A patient in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system to manage asthma.
This system delivers an inhaled powdered form of these combined medications. What instruction should the nurse provide to this patient’s caregivers?

Choice A rationale

Crushing and mixing ciprofloxacin hydrochloride tablets with pudding is not recommended. Ciprofloxacin is an antibiotic used to treat a variety of bacterial infections, including anthrax. It should be taken as directed by a healthcare provider, usually every 12 hours with a full glass of

water. Crushing the tablets can lead to a sudden release of the drug, causing side effects or an overdose.

Choice B rationale

Increasing fluid intake while taking the medication is advisable. Ciprofloxacin can cause crystalluria, which are crystals in the urine, in some patients. Drinking plenty of fluids while taking this medication helps to prevent the formation of these crystals.

Choice C rationale

Using nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild joint aches and pains caused by the medication is not recommended. Ciprofloxacin can increase the effects of certain medications, including NSAIDs, leading to an increased risk of side effects such as gastrointestinal bleeding.

Choice D rationale

Reporting any tendon pain or swelling to the healthcare provider immediately is crucial. Ciprofloxacin has been associated with an increased risk of tendonitis and tendon rupture, particularly in older adults and those taking corticosteroids.

Choice E rationale

Limiting exposure to sunlight and avoiding tanning beds is important. Ciprofloxacin can make the skin more sensitive to sunlight, increasing the risk of sunburn. Patients should wear protective clothing and use sunscreen when outdoors.

Choice A rationale

Administering a narcotic reversal drug is not the first action the nurse should take. While it’s true that the client’s symptoms could be due to opioid overdose, the nurse should first confirm the cause of the symptoms. In this case, the nurse finds four patches on the client’s body, which is unusual and could lead to an overdose. Therefore, the first action should be to remove the patches to prevent further absorption of the drug.

Choice B rationale

Applying an oxygen face mask might be necessary if the client is having difficulty breathing. However, this would not address the underlying problem if the client is experiencing an overdose from the morphine sulfate patches. The nurse should first remove the patches to stop further drug absorption.

Choice C rationale

The nurse finds four patches on the client’s body. This is unusual and could lead to an overdose. Therefore, the nurse’s first action should be to remove the patches to prevent further absorption of the drug. After removing the patches, the nurse can assess the client’s condition and provide further interventions as needed.

Choice D rationale

Monitoring the client’s blood pressure is an important nursing intervention, but it should not be the first action in this situation. The nurse has already found a potential cause for the client’s symptoms (i.e., the four morphine sulfate patches). Therefore, the first action should be to address this problem by removing the patches.