A nurse is caring for an infant who is postoperative following the placement of a ventriculoperitoneal shunt for treatment of hydrocephalus. Which of the following findings should the nurse expect?

Choice A reason: Reporting to the nurse manager is the appropriate and required action. Chemical impairment poses a serious risk to patient safety, and immediate reporting ensures that the situation is addressed according to institutional policy and regulatory standards. This is the correct answer because it prioritizes patient safety and professional accountability.

Choice B reason: Setting up a time to meet with the nurse is inappropriate because it delays intervention and places responsibility on the reporting nurse rather than the manager. It also risks confrontation without proper support.

Choice C reason: Assuming care of the impaired nurse’s clients may temporarily protect patients but does not address the root issue. It also places undue burden on the reporting nurse and fails to follow proper protocol.

Choice D reason: Asking another staff nurse to confirm the suspicion is not appropriate. It risks gossip, breaches confidentiality, and delays necessary intervention. The nurse should report directly to the manager rather than seeking peer validation.

Choice A reason: Fluticasone is an inhaled corticosteroid used for long-term control of asthma. It is not required to be administered before other inhaled medications; bronchodilators are usually given first to open airways before corticosteroids.

Choice B reason: Rinsing the mouth and gargling after each use is correct because inhaled corticosteroids can cause oral candidiasis (thrush). Rinsing removes residual medication and reduces this risk.

Choice C reason: Fluticasone is not used as needed; it is a maintenance medication taken regularly to prevent inflammation. Rescue inhalers such as albuterol are used for acute symptom control.

Choice D reason: Growth may be slowed, not accelerated, in children using inhaled corticosteroids. Monitoring growth is important during long-term therapy.