A nurse teaches a client newly prescribed fluticasone/salmet… | MyMerci
Medical EmergenciesPA
Question
A nurse teaches a client newly prescribed fluticasone/salmeterol combination DPI BID. Which client statement indicates correct understanding of the role of this inhaler?
1"I will alternate this inhaler with albuterol every 4 hours to keep my airways open."
2"I will use this inhaler twice daily for control and continue albuterol for sudden symptoms."✓ Correct answer
3"I will use this inhaler immediately whenever I feel short of breath to relieve wheezing."
4"I will stop using albuterol because this combination inhaler is stronger and works longer."
Explanation
Correct (2): Fluticasone/salmeterol is a controller taken on a fixed schedule (BID); the ICS reduces inflammation and the LABA provides sustained bronchodilation. Albuterol (SABA) remains the rescue for acute symptoms. (1) Not a rescue. (3) Alternating overuses LABA. (4) Albuterol still needed for breakthrough symptoms.
In-depth explanation
Memory Tip Controller vs Rescue: ICS/LABA = daily on schedule; SABA = symptom-based PRN. CPG Some regimens use formoterol-containing combinations as both maintenance and rescue (SMART therapy) — but salmeterol is NOT used this way (too slow onset).
Clinical scenario
Scenario 41-year-old female with persistent asthma starting fluticasone/salmeterol DPI BID. Albuterol MDI continues as rescue.
Key concepts
Controller medication — Daily scheduled asthma drug (ICS, ICS/LABA, LTRA) for inflammation control.