A nurse teaches a client about fluticasone inhaler self-care… | MyMerci
Medical EmergenciesPA
Question
A nurse teaches a client about fluticasone inhaler self-care. Which client statement indicates effective teaching to prevent a common adverse effect?
1"I will take this inhaler only when I have shortness of breath."
2"I will rinse my mouth with water and spit after each use to prevent oral thrush and hoarseness."✓ Correct answer
3"I will use this inhaler before exercise to prevent symptoms."
4"I will increase the dose if my peak flow drops below 50% of baseline."
Explanation
Correct (2): Inhaled corticosteroids deposit on oral and pharyngeal mucosa, predisposing to oropharyngeal candidiasis (thrush) and dysphonia (hoarseness). Rinse and spit after each use; using a spacer also reduces deposition. (1) ICS is a controller, not reliever. (3) Albuterol (SABA) is used pre-exercise. (4) Acute dose changes belong to the asthma action plan with provider.
In-depth explanation
Memory Tip ICS = "Inhale, Rinse, Spit." Spacer + rinse reduce thrush risk dramatically. Treat oral thrush with nystatin swish-and-swallow if it develops.
Clinical scenario
Scenario 26-year-old female with persistent asthma is starting fluticasone DPI 100 mcg BID as a controller. Outpatient teaching about technique and self-care.
Key concepts
Oropharyngeal candidiasis — White plaques on tongue/throat from ICS deposition; treat with nystatin oral suspension.