When auscultating breath sounds of an infant with respiratory syncytial virus, which assessment finding would the nurse immediately report?

Choice A rationale

Discoloration of tooth enamel is not a primary concern with dry powder inhalers. While some medications can cause oral changes, the main issue with inhaled corticosteroids, often delivered via dry powder inhalers, is localized fungal overgrowth, not direct enamel staining. Good oral hygiene is generally recommended but specifically targets fungal prevention.

Choice B rationale

Halitosis, or bad breath, is not a direct or primary consequence of dry powder inhaler use. While poor oral hygiene can contribute to halitosis, the mechanism for rinsing after inhaler use is to remove residual medication, thereby preventing more significant oral complications like fungal infections.

Choice C rationale

Irritation of oral membranes can occur, but it is not the most significant or common complication that rinsing aims to prevent. Residual powder can cause some local irritation, but the predominant risk with long-term use of inhaled corticosteroids, which are frequently in dry powder inhalers, is opportunistic fungal growth.

Choice D rationale

Rinsing the mouth after using a dry powder inhaler, especially one containing corticosteroids, is crucial to prevent candidiasis. Residual corticosteroid particles in the oral cavity can suppress the local immune response, allowing *Candida albicans*, a yeast normally present in small amounts, to proliferate and cause an oral thrush infection.

Choice A rationale

While support groups can be beneficial, this response is premature and dismisses the client's immediate emotional expression. It focuses on a generalized solution rather than exploring the client's individual feelings and the specific reasons for their social withdrawal. Understanding the underlying psychological impact of chronic illness is crucial for providing person-centered care.

Choice B rationale

Prescribing medication is outside the nurse's scope of practice. Furthermore, immediately suggesting an antianxiety agent without a comprehensive assessment of the client's mental and emotional state can mask the true source of their distress and prevent exploration of coping mechanisms or other interventions.

Choice C rationale

This therapeutic communication technique prioritizes active listening and allows the client to elaborate on their feelings and experiences. It demonstrates empathy and respect, fostering a trusting relationship. Understanding the client's perspective is fundamental to developing an individualized and effective care plan for managing the psychosocial challenges of COPD.

Choice D rationale

While friends can offer support, this statement generalizes and might not be relevant to the client's specific situation. It also shifts the focus away from the client's internal experience and onto external factors, potentially minimizing their current distress and the impact of their condition on social engagement.