Medical Surgical COPD #1


The nurse is instructing the client on the use of a beclomethasone (Vanceril) inhaler. Which statement by the client indicates that teaching is successful?


  1. “I will hold my diabetic medication for two hours before and after the inhaler.”
    • Rationale:

      This answer is not correct because it is not necessary to hold diabetic medications. Steroid use may raise blood sugar and holding diabetic medications may cause a higher blood sugar level.

  2. “I will rinse my mouth following each scheduled dose.”
    • Rationale:

      This answer is correct because the client should rinse the mouth following each scheduled dose because of irritation to the mucous membranes and possibility of creating an environment for candidiasis since the medication is a steroid.

  3. “I will use the inhaler prior to sleep.”
    • Rationale:

      This answer is not correct because corticosteroid inhalers are scheduled for daytime use in order to prevent bronchial inflammation throughout the day. Nighttime use of steroids can interfere with sleep.

  4. “I will inhale then blow out forcefully.”
    • Rationale:

      This answer is not correct because this is not the proper way to use an inhaler. The client should first exhale so that they are able to take a deep breath in when using the inhaler, so that they get the full dose of medication.


The focus of this question is the evaluation of client learning following instruction on the proper use of a corticosteroids inhaler. Rinsing the mouth out after the use of an inhaler containing a corticosteroid indicates that the client understands teaching.


Learning Outcomes

Beclomethasone is a corticosteroid medication used to help decrease the inflammation within the airways of clients with certain respiratory conditions such as COPD. Corticosteroids, when inhaled can irritate the mucus membranes within the oral cavity leading to the development of oral candidiasis or thrush. The client should be taught to use their steroid inhaler last and to rinse the mouth after each use.

Test Taking Tip

Medications ending in -sone are typically steroids. Steroid inhalers place the client at risk for oral thrush, so it is imperative to teach the client to rinse the mouth after each use.

Video Rationale