Report white oral patches, severe sore throat, or difficulty swallowing.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client on long-term inhaled corticosteroids should be taught to rinse the mouth after use to prevent:
Answer: B. Rinsing after inhaled corticosteroids prevents oral candidiasis (thrush). It does not cause systemic hypoglycemia or staining; rinsing reduces local steroid effects in the mouth.
Question 2 of 5
A nurse is providing teaching to a client newly prescribed an inhaled corticosteroid (fluticasone). Which instruction is most important to prevent a common local adverse effect?
Answer: A. Inhaled corticosteroids commonly cause oral candidiasis (thrush) and hoarseness because the drug deposits in the mouth and throat. Rinsing the mouth with water and spitting after each use removes residual medication and greatly reduces these local effects. Inhaled steroids are controller medications and must be used daily, not only during attacks.
Question 3 of 5
A client on long-term oral corticosteroids asks about stopping them. The nurse teaches to:
Answer: B. Never stop corticosteroids abruptly — taper to avoid adrenal crisis. Also take with food, monitor glucose, and watch for infection (immunosuppression).
Question 4 of 5
A nurse is assessing a client who has been receiving high-dose IV corticosteroids. Which finding requires immediate intervention?
Answer: B. Corticosteroids cause sodium and water retention and can precipitate or worsen heart failure and hyperglycemia. New crackles in the lungs with shortness of breath and weight gain suggest fluid overload and require immediate intervention. Mild mood elevation, increased appetite, and a slightly rounded face are expected effects that are not emergencies.
Question 5 of 5
A client with ITP is prescribed corticosteroids. The nurse explains that this medication is used to achieve what effect?
Answer: A. In ITP, the immune system destroys platelets. Corticosteroids suppress this immune response, reducing platelet destruction and raising the platelet count. They do not directly stimulate platelet production in the marrow.
Keep the streak going with more questions like these, each with a full rationale.
What is inhaled corticosteroids?
They are taken daily for long-term control and do NOT relieve an acute attack. The hallmark teaching point is to rinse the mouth after use to prevent oral thrush.
Key points to remember
- They are maintenance anti-inflammatory drugs, not rescue medications.
- Oral candidiasis (thrush) and hoarseness are the main local side effects.
- Use a spacer with an MDI to improve delivery and reduce thrush.
- When given with a bronchodilator, the bronchodilator is administered first to open airways.
- Long-term high-dose use in children can slow growth and may affect bone density.
Signs & symptoms
- Oral candidiasis, hoarseness
- Kids → monitor growth
Nursing priorities
- Teach the patient to rinse mouth and spit after each use to prevent thrush.
- Inspect the mouth for white patches suggesting candidiasis.
- Reinforce daily use for control and continued use of a separate rescue inhaler.
- When ordered with a bronchodilator, give the bronchodilator first, then the steroid.
Patient teaching
- Rinse your mouth with water and spit it out after every dose.
- Use it every day even when you feel fine; it prevents attacks rather than stopping them.
- Use a spacer if prescribed and keep your rescue inhaler for sudden symptoms.
Red flags: report now
- Report white oral patches, severe sore throat, or difficulty swallowing.
- Never use this inhaler to stop an acute asthma attack.
References
Clinical references for this topic
