A child with seasonal rhinitis has used budesonide (Rhinocort Aqua) for several years. The parents are concerned that the child's rate of growth has slowed. What will the nurse do?
a. Reassure the parents that this is an expected side effect.
b. Suggest that the parents discuss using fluticasone (Flonase) with the provider.
c. Tell the parents to administer the drug only when symptoms are severe.
d. Tell the parents that antihistamines work as well as intranasal glucocorticoids.
ANS: B
A worrisome systemic effect of intranasal glucocorticoids is suppression of linear growth in children. Although rare, it can occur; however, it is less likely with fluticasone and mometasone, so these two preparations are better options for children. Reassuring parents that this is an expected side effect is incorrect. Intranasal glucocorticoids should be given daily and not as needed. Antihistamines are not as effective as glucocorticoids, because antihistamines work only against one mediator of allergic inflammation.
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