Medical Surgical Asthma #1

Question

The nurse is instructing a client on using a metered-dose inhaler and will include which instructions? Select all that apply.

Answers

  1. Hold the metered-dose inhaler 1-2 inches from mouth or use a spacer.
    • Rationale:

      This answer is correct because the nurse should instruct the client to hold the metered-dose inhaler 1-2 inches from mouth (or two-finger-breadths away) or use a spacer. This is appropriate teaching on the use of a metered-dose inhaler.

  2. After inhalation, close the mouth and hold the breath for 5-10 seconds.
    • Rationale:

      This answer is correct because the client should be instructed to close the mouth and hold breath for several seconds (10 seconds if possible). This action allows for full absorption of the medication.

  3. Take short quick breaths with each inhalation.
    • Rationale:

      This answer is not correct because instruction is to breathe deeply through the mouth with each inhalation, NOT short quick breaths. This does not allow for complete absorption of the medication and is not proper education on the use of a metered-dose inhaler.

  4. Exhale deeply after inhalation of medication.
    • Rationale:

      This answer is not correct because the client should only exhale forcefully PRIOR to actually using the inhaler. The client is then instructed to inhale deeply when using the inhaler.

  5. Hold breath for 20 seconds before inhaling the medication then exhaling.
    • Rationale:

      This answer is not correct because the client should be instructed to hold their breath after inhaling the medication to allow for full absorption of the medication. Also, holding the breath for 20 seconds may not be possible for many clients.

Overview

The focus of this question is providing the appropriate client education on the use of a metered-dose inhaler. The inhaler should be held 1-2 inches away from the mouth if a spacer is not being used and the client should hold their breath for a few seconds to allow for full absorption of the medication.

Explanation

Learning Outcomes

A metered-dose inhaler is a small, hand-held inhaler used to deliver a specific amount of medication for clients with respiratory conditions such as asthma. There may be an increased amount of side effects because the medication is delivered directly to the lungs so proper use of the inhaler is essential. A spacer may be attached to the mouthpiece of the device to ensure the proper amount of distance between the mouthpiece and the client’s mouth. If there is no spacer present, the client should be instructed to hold the device 1-2 inches from the mouth during use. The client should also be instructed to hold the breath for 5-10 seconds after each dose to avoid exhaling the medication.

Test Taking Tip

Client education regarding the use of inhalers is a very testable topic both on nursing school exams and on NCLEX. Make sure you understand this information well. The nurse should instruct the client to hold the metered dose inhaler 1-2 inches from the mouth (or two-finger-breadths away) or use a spacer. Exhalation should be after breath is held for up to 10 seconds if possible, and should not be forceful to retain the medication.

Video Rationale