The nurse teaches a client who is starting inhaled fluticasone for persistent asthma. Which statement by the client indicates correct understanding?
1I will use fluticasone for rapid relief whenever sudden wheezing begins.
2I will double the prescribed dose whenever my peak flow falls below my usual range.
3I will rinse my mouth with water and spit after each dose to reduce the risk of thrush.✓ Correct answer
4I will stop the controller as soon as I have one day without asthma symptoms.
Explanation
Fluticasone is an inhaled corticosteroid used for maintenance treatment, not rapid relief of acute bronchospasm. Rinsing the mouth with water without swallowing after inhalation reduces medication deposition and the risk of oropharyngeal candidiasis. The client should use a prescribed rescue bronchodilator for acute symptoms and should not double or discontinue the controller independently.
Clinical reasoning Local corticosteroid deposition in the mouth and pharynx can promote Candida infection and hoarseness. Rinsing and spitting removes residual medication.
Decision rule Use inhaled fluticasone consistently as a controller, rinse the mouth without swallowing after each dose, and keep the prescribed rescue medication available for acute bronchospasm.
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.
Inhaled corticosteroid — A maintenance anti-inflammatory asthma medication that reduces airway inflammation but does not provide immediate rescue bronchodilation.
Oropharyngeal candidiasis — A localized Candida infection of the mouth or pharynx whose risk is reduced by rinsing and spitting after corticosteroid inhalation.
Dysphonia — Hoarseness from ICS deposition on vocal cords; reduced by rinsing and spacer use.