A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

A) Using up to 40 nicotine lozenges per day is excessive. The typical recommendation is to limit the use of nicotine lozenges to 5-6 per day, as excessive use can lead to nicotine toxicity and increased withdrawal symptoms.

B) Substituting tobacco use with an electronic cigarette is not recommended as a treatment option. While e-cigarettes may reduce exposure to some harmful substances found in traditional tobacco products, they can still maintain nicotine addiction and are not a clinically approved smoking cessation method.

C) Limiting the use of nicotine gum to 6 months is appropriate. While nicotine replacement therapies can be helpful for managing withdrawal symptoms, prolonged use beyond 6 months may not be beneficial and can maintain dependence on nicotine.

D) Using progressively larger nicotine patches is not the recommended approach. Nicotine patches should typically be started at a prescribed dose based on the client's previous nicotine use and adjusted as necessary, rather than increasing the dose without proper guidance.

A) "I should use a soft-bristle toothbrush to clean my teeth after meals.": Using a soft-bristle toothbrush is crucial for clients with stomatitis, as it minimizes irritation to sensitive oral tissues. Gentle oral hygiene practices help maintain oral health and reduce discomfort, indicating that the client understands the need for careful dental care during radiation therapy.

B) "I should limit my intake of dairy products to prevent nausea.": While some clients may experience nausea, limiting dairy is not typically recommended for managing stomatitis. In fact, dairy can be soothing for some individuals. This statement does not address the specific needs related to stomatitis and indicates a misunderstanding of dietary management during treatment.

C) "I should gargle with an alcohol-based mouthwash to kill germs.": Alcohol-based mouthwashes can further irritate the mucous membranes and exacerbate stomatitis symptoms. Acknowledging this would demonstrate a lack of understanding, as alcohol is contraindicated in the management of oral mucosal irritation caused by radiation therapy.

D) "I should moisten my lips with lemon-glycerin swabs.": Lemon-glycerin swabs can actually irritate the mouth and exacerbate discomfort in clients with stomatitis. This approach is not recommended, and selecting such a treatment indicates a misunderstanding of appropriate oral care measures during radiation therapy.