A nurse is providing teaching to a client who has new prescriptions for beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?

Choice A rationale Beclomethasone is an inhaled corticosteroid. Gargling with water after use is essential to reduce the local deposition of the medication in the oropharynx. This minimizes the risk of developing oral candidiasis, commonly known as thrush, and hoarseness, which are common local side effects associated with inhaled corticosteroid use. Choice B rationale Beclomethasone, like most inhaled suspensions, requires shaking prior to use. Shaking ensures that the medication is evenly dispersed within the propellant or solution. This uniform dispersion is critical for delivering an accurate and consistent dose with each actuation, maximizing therapeutic efficacy and minimizing variability. Choice C rationale Beclomethasone is a long-acting inhaled corticosteroid used for the *maintenance* and *preventive* treatment of asthma. It works by reducing airway inflammation over time, not by providing immediate bronchodilation. Therefore, it is ineffective for and should not be used during an acute asthma attack, which requires a rapid-acting bronchodilator. Choice D rationale For optimal benefit, the short-acting bronchodilator, albuterol, should be used *before* beclomethasone. Albuterol opens the airways, allowing for better penetration of the inhaled corticosteroid into the lower respiratory tract. This sequential administration enhances the delivery and absorption of beclomethasone, improving its anti-inflammatory effects.