Which principle(s) would be included when teaching a patient to use a steroid inhaler? (Select All that Apply.)

A. Mouth breathing is common after a tonsillectomy due to postoperative swelling and discomfort. It is not specifically a sign of hemorrhage. Instead, it is a typical adjustment as the child copes with throat pain and may find it easier to breathe through the mouth.
B. While reports of pain are expected after a tonsillectomy due to the nature of the surgery, they are not indicative of hemorrhage. Pain management is an important part of postoperative care, but increased pain alone does not signal bleeding.
C. Frequent swallowing can be a significant manifestation of hemorrhage following a tonsillectomy. This behavior may indicate that the child is trying to clear blood or secretions from the throat, or it may suggest that the child is swallowing blood that is pooling in the throat. It is an important sign for the nurse to monitor, as it can indicate active bleeding.
D. Reports of thirst are common after surgery due to fasting before the procedure and the dry mouth that can result from mouth breathing or the surgical site itself. While excessive thirst should be addressed, it is not a direct indicator of hemorrhage.

A. Rinsing the mouth and spitting after using a steroid inhaler is essential to prevent oral thrush, a common side effect of inhaled corticosteroids. This practice helps clear residual medication from the mouth and throat, reducing the risk of fungal infections.
B. Bronchodilators, such as short-acting beta-agonists (SABAs), should be used before steroid inhalers. The bronchodilator opens the airways, allowing the steroid to reach deeper into the lungs for better efficacy.
C. While some inhalers (like rescue inhalers) may be used on a PRN basis, steroid inhalers are typically prescribed for regular, daily use to manage inflammation and control chronic conditions like asthma or COPD. They are not intended for PRN use only.
D. Frequent oral hygiene helps to reduce the risk of oral thrush and other oral health issues associated with steroid use. Patients should be encouraged to maintain good oral hygiene practices while using inhaled steroids.
E. Holding the breath for about 10 seconds after inhalation allows for better medication absorption in the lungs. This practice helps maximize the efficacy of the inhaled medication.