A client with psoriasis returns to the clinic reporting the persistence of several silvery, scaly areas on the elbows and palms that frequently burn and sometimes bleed.
Which prescription should the nurse teach the client to use for the skin condition?

Choice A rationale:

Checking the patient's temperature again is not a priority at this time. The patient's temperature is within the normal range, and there is no indication that it is the cause of the patient's hypoxia.

Focusing on temperature measurement could delay more crucial interventions to address the patient's breathing difficulty.

Choice B rationale:

While monitoring the patient's heart rate is important, it is not the most immediate priority in this situation. The patient's heart rate is elevated, but it is not dangerously high.

The elevated heart rate is likely a compensatory response to the patient's low oxygen saturation. Addressing the underlying cause of the hypoxia, which is likely respiratory in nature, will also help to stabilize the heart rate.

Choice C rationale:

Observing the patient's breathing is the most important action the nurse can take at this time. The patient's respirations are rapid and shallow, indicating respiratory distress.

This is a serious condition that requires immediate intervention. By observing the patient's breathing, the nurse can assess the severity of the distress and determine the best course of action.

The nurse can observe for signs of increased work of breathing, such as use of accessory muscles, nasal flaring, and retractions. They can also auscultate the lungs to assess for any abnormal breath sounds, such as wheezing or crackles.

This information will help the nurse to determine the underlying cause of the respiratory distress and to initiate appropriate interventions, such as administering oxygen, positioning the patient, or calling for assistance from a respiratory therapist.

Choice D rationale:

Checking the patient's blood pressure is not a priority at this time. The patient's blood pressure is within the normal range. While it is important to monitor the patient's blood pressure, it is not the most immediate concern in this situation.

Choice A rationale:

Tiotropium is a long-acting bronchodilator, not a rescue inhaler for sudden shortness of breath.

It takes several hours to reach its full effect and is not designed to provide immediate relief during acute symptoms.

Using tiotropium for sudden shortness of breath could delay the use of a more appropriate rescue medication, potentially worsening the situation.

Choice B rationale:

While tiotropium can help reduce mucus production and make secretions easier to clear, this is not its primary mechanism of action.

The client's statement focuses on a potential side effect rather than demonstrating a clear understanding of the medication's intended purpose.

Choice C rationale:

The frequency of inhaler use depends on the specific medications prescribed. Some inhalers are used daily, while others are used only as needed for symptoms.

It's essential to follow the healthcare provider's instructions for each inhaler to ensure proper use and avoid potential drug interactions.

Choice D rationale:

This statement correctly reflects the appropriate use of tiotropium.

It's typically taken once daily via a handihaler device to maintain open airways and prevent COPD symptoms. Regular daily use is crucial for optimal effectiveness.