A nurse is discussing the use of docusate sodium (Colace) with a client who is recovering from a non-ST elevation myocardial infarction (NSTEMI). What is the rationale for administering this medication during the recovery from a myocardial infarction?

A. Fluticasone is an inhaled corticosteroid used primarily for maintenance therapy in COPD and asthma. It helps reduce airway inflammation and prevent exacerbations but is not used for immediate relief of acute symptoms such as bronchospasm or sudden shortness of breath.
B. Fluticasone, like other corticosteroids delivered by inhalation, can increase the risk of oral thrush (candidiasis) due to its local immunosuppressive effects in the mouth. It's important for clients to monitor their oral cavity regularly for signs such as white patches or soreness. Including this instruction is crucial to detect thrush early so that appropriate treatment can be initiated if necessary.
C. Monitoring heart rate is not specifically necessary before each dose of fluticasone. Fluticasone is not known to cause significant cardiovascular effects such as changes in heart rate. Heart rate monitoring may be more relevant for medications that can affect cardiovascular function or in clients with pre- existing cardiac conditions.

D. Fluticasone should be used regularly as prescribed for maintenance therapy to control airway inflammation and prevent exacerbations in COPD. Skipping doses, even if symptoms are not present, can lead to inadequate control of the disease and potential worsening of symptoms over time.

A. Barrel chest is a physical finding commonly associated with COPD due to hyperinflation of the lungs. It results from chronic air trapping and enlargement of the chest. While barrel chest is not directly caused by cor pulmonale, it is a characteristic feature of advanced COPD.
B. Clubbing of the fingers is not directly caused by cor pulmonale. It is typically associated with chronic hypoxia, which can occur in advanced lung diseases like COPD. Clubbing involves changes in the shape and texture of the nails and fingertips due to chronic lack of oxygen in the blood.
C. Destruction of the alveoli is a hallmark of emphysema, which is a type of COPD. Emphysema leads to loss of lung tissue elasticity and surface area, contributing to chronic airflow limitation. While emphysema is a risk factor for developing cor pulmonale, destruction of alveoli itself does not directly cause cor pulmonale.
D. Peripheral edema is a manifestation caused by cor pulmonale. When the right side of the heart fails (cor pulmonale), it leads to increased pressure in the pulmonary circulation, which can eventually cause fluid to leak out into the tissues, resulting in peripheral edema. This is a consequence of the right heart's inability to effectively pump blood forward due to pulmonary hypertension and subsequent right ventricular failure.