# A nurse teaches a client about using a metered-dose inhaler with a spacer. Which client statement indicates the teaching has been effective?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391770&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A nurse teaches a client about using a metered-dose inhaler with a spacer. Which client statement indicates the teaching has been effective?

## Option

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."

**Correct answer: 2**

## 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.

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