The nurse is providing discharge teaching for a client with asthma that has been prescribed inhaled beclomethasone. Which of the following instructions should the nurse include?

Take the medication with meals.

Limit caffeine intake.

Rinse the mouth after administration.

Check the pulse before and after medication administration.

Answer and Explanation

The Correct Answer is C

A) Take the medication with meals:
Inhaled beclomethasone is a corticosteroid, and it is generally not necessary to take it with meals. Oral corticosteroids are sometimes taken with meals to minimize gastric irritation, but this does not apply to inhaled corticosteroids like beclomethasone. The primary concern with inhaled corticosteroids is not related to meal timing but to oral hygiene to prevent side effects like oral thrush.

B) Limit caffeine intake:
There is no direct contraindication or requirement to limit caffeine intake when taking inhaled beclomethasone. While caffeine can have mild bronchodilatory effects, it does not interfere with the action of beclomethasone or exacerbate asthma symptoms. This is not a priority teaching point for the patient.

C) Rinse the mouth after administration:
One of the most important teaching points when using inhaled beclomethasone is to rinse the mouth after each use. This helps to prevent oral thrush (a fungal infection caused by Candida), which is a common side effect of inhaled corticosteroids. Rinsing the mouth with water after administration helps to remove any leftover medication and reduce the risk of infection, making this the most important instruction.

D) Check the pulse before and after medication administration:
While checking the pulse is important for some medications, such as bronchodilators like albuterol, it is not necessary for inhaled beclomethasone. Beclomethasone is a corticosteroid that primarily works by reducing inflammation in the airways, and it does not have a significant impact on heart rate. Therefore, it is not required to monitor pulse before and after its use.

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Correct Answer is D

Explanation

A) Assess the client's potassium level:
While electrolyte imbalances, including low potassium, can contribute to symptoms like restlessness or muscle weakness, it is not the first priority in a client with COPD who suddenly becomes restless and anxious. Restlessness and anxiety in this context are more likely to be due to hypoxia (low oxygen levels), hypercapnia (high carbon dioxide levels), or respiratory distress.

B) Check the client's temperature:
An elevated temperature may indicate an infection, such as pneumonia or a respiratory tract infection, which can exacerbate COPD symptoms. However, in the context of sudden restlessness and anxiety, this is less likely to be the most immediate cause. The primary concern should be addressing the potential respiratory issues, such as hypoxia or acute exacerbation, rather than focusing on fever, unless other signs of infection are present.

C) Increase the client's oxygen flow rate to 15 L/min:
While it is important to ensure adequate oxygenation in a client with COPD, increasing the oxygen flow rate to 15 L/min may not be appropriate, as COPD patients are typically at risk for oxygen-induced hypercapnia. These patients often rely on low levels of oxygen to stimulate breathing, and administering high-flow oxygen can suppress their respiratory drive, potentially worsening carbon dioxide retention.

D) Encourage the client to perform pursed-lip breathing:
Pursed-lip breathing is a highly effective technique for COPD patients to help increase oxygenation and decrease the work of breathing. This technique involves the client breathing in through the nose and exhaling slowly through pursed lips, which helps to keep the airways open longer and facilitates the removal of trapped air in the lungs.

A. Stop taking, ordered corticosteroid once symptoms resolve. B. Apply warm compresses to the affected several times a day. C. Cover the affected eye with eye eye protective shield or patch at night. D. Chew food only on the affected side. E. Place artificial tears or lubricant to help decrease dryness in the eyes

Correct Answer is ["B","C","E"]

Explanation

A) Stop taking ordered corticosteroid once symptoms resolve:
Corticosteroids, such as prednisone, are commonly prescribed to reduce inflammation in Bell’s Palsy, especially during the acute phase. However, it is important to complete the full course of corticosteroids as prescribed, even if symptoms improve. Abruptly stopping corticosteroids can lead to rebound inflammation and potentially worsen the condition.

B) Apply warm compresses to the affected area several times a day:
Warm compresses can help to reduce pain and inflammation in the affected side of the face. Applying them several times a day can also help improve circulation and ease the discomfort associated with Bell's Palsy. This is a recommended self-care strategy that can help provide relief and improve overall comfort for the client during recovery.

C) Cover the affected eye with an eye protective shield or patch at night:
Bell's Palsy can lead to paralysis of the facial muscles, which may make it difficult for the client to fully close the eyelid on the affected side, leaving the eye vulnerable to dryness and injury. Covering the eye with a protective shield or patch at night helps prevent corneal damage and protects the eye from exposure during sleep. This is an essential part of eye care for a client with Bell’s Palsy to prevent complications.

D) Chew food only on the affected side:
There is no medical recommendation to limit chewing to the unaffected side. In fact, clients should be encouraged to use both sides of their mouth for chewing to prevent muscle atrophy and maintain function. There is no evidence to support that chewing food only on the affected side provides any benefit.

E) Place artificial tears or lubricant to help decrease dryness in the eyes:
Since Bell's Palsy can impair the ability to close the eyelid fully, this can lead to dryness and potential corneal damage on the affected side. Artificial tears or lubricating eye drops should be used regularly to moisturize the eye and prevent complications such as corneal ulcers or abrasions.

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The nurse is providing discharge teaching for a client with asthma that has been prescribed inhaled beclomethasone. Which of the following instructions should the nurse include?

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Explanation

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Correct Answer is ["B","C","E"]

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