Question

an older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease. when administering the drug, what action should the nurse perform to reduce the clients risk for developing oral candidiasis?

have the resident rinse their mouth after each dose of the drug.
have the client gargle with normal saline prior to administering the drug.
encourage the resident not to deeply inhale the medication.
administer prophylactic antifungal medications.

Explanation:

Identify the clinical problem

The question asks for a nursing action to reduce the risk of oral candidiasis (thrush) in an older adult client prescribed an inhaled corticosteroid for chronic obstructive pulmonary disease (COPD).

Analyze the mechanism of action

Inhaled corticosteroids can deposit in the oral cavity and pharynx during inhalation. Local immunosuppression from the residual steroid on the oral mucosa promotes the overgrowth of Candida albicans, leading to oral candidiasis.

Evaluate the intervention options

Using Inhaler Technique principles, removing the residual drug from the oral cavity is key to preventing local side effects.

• Rinsing the mouth with water and spitting it out after each dose physically removes the deposited corticosteroid.
• Gargling with saline prior to administration does not remove post-dose residue.
• Avoiding deep inhalation reduces drug delivery to the lungs, compromising therapeutic efficacy.
• Prophylactic antifungals are not indicated for routine prevention.

Select the correct option

Rinsing the mouth with water after each dose is the standard, evidence-based nursing intervention to prevent oral candidiasis.

Answer:

• Have the resident rinse their mouth after each dose of the drug. (Correct answer)
• Have the client gargle with normal saline prior to administering the drug.
• Encourage the resident not to deeply inhale the medication.
• Administer prophylactic antifungal medications.