RN Nursing · Bronchodilator and Anti-Inflammatory Respiratory Medications · Practice question
A nurse is teaching a client who has asthma how to use a metered-dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. (Use the ▲▼ arrows to put the steps in order, placing them in the selected order of performance. Use all steps.)
Answer & explanation
Correct:
Correct MDI technique follows a deliberate sequence. First the client exhales completely (item 2, inhale deeply and then exhale completely) to empty the lungs and create room for medication to be drawn deep into the airways. Next she places her lips firmly around the mouthpiece (item 5) to create a tight seal so no aerosol escapes. She then breathes in deeply over two to three seconds while simultaneously pushing down on the canister (item 3); coordinating actuation with slow inspiration carries the drug past the oropharynx into the bronchioles. After inhalation she holds her breath for ten seconds (item 4) to allow medication particles to deposit on the airway mucosa rather than being immediately exhaled. She then exhales slowly through pursed lips (item 1), which keeps small airways open and prevents rapid airway collapse, especially helpful in obstructive disease. Finally she waits sixty seconds between puffs (item 0) so the first dose can begin to bronchodilate the airways, allowing the second puff to penetrate more deeply. Common errors include actuating before sealing the lips, inhaling too fast, skipping the breath-hold, or stacking puffs without waiting, all of which markedly reduce drug delivery.
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