To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Choice A reason: Confirming that the daughter is aware of the progressive nature of the disease is not the best response, as it does not address the daughter's misconception about the drug. The nurse should educate the daughter that rivastigmine does not cure or stop the progression of Alzheimer's disease, but only slows down the cognitive decline.

Choice B reason: Affirming the decision to use the medication when the symptoms start to worsen is not appropriate, as it contradicts the evidence-based practice. The nurse should inform the daughter that rivastigmine is most effective when used in the early stages of Alzheimer's disease, as it can delay the need for institutionalization and improve the quality of life.

Choice C reason: Explaining that the drug should be used early in the course of the disease process is the best response, as it corrects the daughter's misunderstanding and provides accurate information. The nurse should explain that rivastigmine works by inhibiting the enzyme that breaks down acetylcholine, a neurotransmitter that is involved in memory and learning. By increasing the level of acetylcholine in the brain, rivastigmine can improve the cognitive function and behavior of the client.

Choice D reason: Assessing the client's current mental status before deciding to support the decision is not relevant, as it does not address the daughter's concern or the rationale for the drug. The nurse should already have the client's baseline mental status from the initial assessment and diagnosis. The nurse should focus on educating the daughter about the benefits and risks of rivastigmine and encouraging her to follow the prescribed regimen.

Choice A reason: This is not an appropriate action for the nurse to take. Increasing the intake of saturated fats will worsen the side effects of orlistat, which inhibits the absorption of fats in the intestine. The client should be advised to follow a low-fat diet while taking orlistat.

Choice B reason: This is not an appropriate action for the nurse to take. Oily stools and flatus are common and expected side effects of orlistat, and they do not indicate a serious adverse reaction. The client does not need to stop taking the drug or contact her healthcare provider unless the symptoms are severe or persistent.

Choice C reason: This is not an appropriate action for the nurse to take. Obtaining a stool specimen to evaluate for occult blood and fat content is not necessary for a client taking orlistat. The presence of fat in the stool is normal and expected with orlistat, and there is no evidence of bleeding in the client's case.

Choice D reason: This is the appropriate action for the nurse to take. Asking the client to describe her dietary intake history for the last several days will help the nurse assess the client's compliance with the recommended low-fat diet and provide education and counseling as needed. The nurse can also monitor the client's weight loss progress and adjust the dosage of orlistat accordingly.