To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

A) Clients using the discus may experience decreased blood pressure: This statement is incorrect. Fluticasone propionate and salmeterol are not typically associated with decreased blood pressure; rather, they may have other cardiovascular effects. B) Offer the discus to the client for use during an acute asthma attack: This is inappropriate. The discus is a maintenance medication system and is not meant for immediate relief during an acute asthma attack. Clients should use a rescue inhaler (like albuterol) for such situations. C) When using the discus, have the client breathe out rapidly into the mouthpiece: This instruction is misleading. The correct technique involves breathing in quickly and deeply through the mouthpiece after activating the discus, not blowing out into it. D) Explain that the client should not use the discus more than twice daily: This is the correct instruction. The combination of fluticasone propionate and salmeterol is intended for twice-daily use to maintain control of asthma symptoms, and caregivers should ensure that the client adheres to this dosing schedule.