A nurse assesses a client who is prescribed fluticasone and notes oral lesions.
What action would the nurse take?

Choice A rationale

Long-acting beta agonists (LABAs) are not rescue medications and should not be carried for immediate use during an asthma attack. Their onset of action is too slow to provide rapid relief, and their use for acute symptoms could mask worsening asthma, delaying appropriate treatment with a short-acting beta agonist.

Choice B rationale

LABAs are designed for maintenance therapy to prevent asthma symptoms over an extended period. Taking them only when an asthma attack begins is an inappropriate use, as they are not meant for acute symptom relief and will not provide immediate bronchodilation required during an exacerbation.

Choice C rationale

LABAs are prescribed as a daily maintenance medication to provide sustained bronchodilation and help prevent acute asthma attacks. Consistent daily use, typically in the morning, helps to control airway inflammation and reactivity, reducing the frequency and severity of future exacerbations by maintaining open airways.

Choice D rationale

Weaning off LABA medication should only be done under the direct supervision of a healthcare provider. Abrupt discontinuation can lead to a rebound in asthma symptoms. The decision to discontinue or adjust medication is based on a comprehensive assessment of asthma control and lung function, not just symptom absence.

Choice A rationale

Discoloration of tooth enamel is not a primary concern with dry powder inhalers. While some medications can cause oral changes, the main issue with inhaled corticosteroids, often delivered via dry powder inhalers, is localized fungal overgrowth, not direct enamel staining. Good oral hygiene is generally recommended but specifically targets fungal prevention.

Choice B rationale

Halitosis, or bad breath, is not a direct or primary consequence of dry powder inhaler use. While poor oral hygiene can contribute to halitosis, the mechanism for rinsing after inhaler use is to remove residual medication, thereby preventing more significant oral complications like fungal infections.

Choice C rationale

Irritation of oral membranes can occur, but it is not the most significant or common complication that rinsing aims to prevent. Residual powder can cause some local irritation, but the predominant risk with long-term use of inhaled corticosteroids, which are frequently in dry powder inhalers, is opportunistic fungal growth.

Choice D rationale

Rinsing the mouth after using a dry powder inhaler, especially one containing corticosteroids, is crucial to prevent candidiasis. Residual corticosteroid particles in the oral cavity can suppress the local immune response, allowing *Candida albicans*, a yeast normally present in small amounts, to proliferate and cause an oral thrush infection.