A client on flunisolide reports painful, white patches in their mouth. What is the most appropriate nurse response?

The presence of painful, white patches in the mouth, particularly in a client using flunisolide, raises concern for a potential fungal infection, commonly oral candidiasis (thrush). Flunisolide is an inhaled corticosteroid, and one of the well-known side effects of inhaled corticosteroids is the development of oral thrush due to local immune suppression in the oral cavity.

When corticosteroids are used, they can alter the normal flora of the mouth, leading to overgrowth of Candida species. This makes it crucial for the nurse to assess the lesions more closely and consider that the patches might indeed be indicative of an infection rather than just a benign or expected side effect. Therefore, the most appropriate nursing response is to indicate that a fungal infection is likely and requires treatment to manage it effectively. Proper identification and management of this condition will help in alleviating the client’s discomfort and prevent further complications.

Options indicating that this symptom is expected or just a side effect downplay the seriousness of the situation and may delay appropriate treatment. Additionally, while improving oral hygiene can help in preventing the occurrence of thrush, it would not address the immediate need for treatment if there is an active infection present.