A nurse teaches a client about using a metered-dose inhaler … | MyMerci
Medical EmergenciesPA
Question
A nurse teaches a client about using a metered-dose inhaler with a spacer. Which client statement indicates the teaching has been effective?
1"I will press the canister, then immediately inhale rapidly and forcefully."
2"I will press the canister, breathe in slowly and deeply over 3-5 seconds, then hold my breath for 10 seconds."✓ Correct answer
3"I will exhale fully into the spacer before inhaling the dose."
4"I will press the canister twice quickly during one breath for a double dose."
Explanation
Correct (2): Correct MDI with spacer technique: shake → exhale away from device → seal lips around mouthpiece → press canister ONCE → inhale slowly and deeply over 3-5 seconds → hold breath for 10 seconds → exhale slowly. Wait at least 30-60 seconds between puffs. (1) Rapid forceful inhalation causes drug to deposit in throat, not lungs. (3) Double-pressing wastes the dose. (4) Exhaling INTO the spacer contaminates and dilutes the dose.
In-depth explanation
Memory Tip MDI = "Shake-Exhale-Seal-Press-Slow-Deep-Hold." Spacer reduces oropharyngeal deposition by ~80% and improves lung delivery.
Clinical scenario
Scenario 9-year-old child newly prescribed albuterol MDI with spacer. The nurse is providing first-time technique teaching with the parent.
Key concepts
Spacer device — Holding chamber attached to MDI; improves drug delivery and reduces oral deposition.
MDI technique — Press canister once, inhale slowly and deeply, hold breath 10 seconds.
Inhaler order — When prescribed both: bronchodilator FIRST, then corticosteroid; rinse mouth after corticosteroid.