A patient with COPD has been prescribed fluticasone (inhaled steroid) and complains of throat soreness. What action would the nurse take?

Choice A reason: Obtaining an oral specimen for culture assumes infection, but throat soreness in fluticasone use is typically due to local irritation or candidiasis from steroid deposition. Cultures are unnecessary unless signs of infection (e.g., white patches) appear, making this action premature and less appropriate than preventive measures. Choice B reason: Throat soreness from fluticasone is caused by steroid residue irritating the oropharynx or promoting candidiasis. Teaching oral rinsing after inhalation removes residual drug, reducing irritation and fungal growth risk, improving patient comfort and adherence while preventing complications without altering the COPD treatment regimen. Choice C reason: Documenting throat soreness as a known side effect is appropriate but passive. It does not address the patient’s discomfort or prevent complications like oral candidiasis. Proactive teaching of oral rinsing is more effective, as it mitigates the cause, making documentation alone an insufficient initial response. Choice D reason: Discontinuing fluticasone is inappropriate, as it is essential for controlling COPD inflammation. Throat soreness is a manageable side effect, not a reason to stop therapy. Rinsing after use prevents irritation and candidiasis, allowing continued treatment while addressing the patient’s complaint effectively.