What is the best way to confirm that an asthmatic outpatient can ...

[NguyenJ]

What is the best way to confirm that an asthmatic outpatient can properly self-manage a newly prescribed aerosol drug therapy?
 
  a. Have the patient describe the proper pro-cedural steps.
  b. Have the patient provide a repeat or return demonstration.
  c. Have the patient take a written or oral quiz on technique.
  d. Have the patient maintain detailed treat-ment logs.

Question 2

After administering 12 puffs of metered dose inhaler (MDI) albuterol to an acutely ill asthmatic patient in the emergency department, assessment indicates no significant improvement in symp-toms. Which of the following would you now recommend?
 
  a. Switch over to high-dose MDI steroids.
  b. Discontinue the bronchodilator therapy.
  c. Use continuous bronchodilator therapy.
  d. Switch over to an anticholinergic agent.

[Jossy]

Answer to Question 1

ANS: B
Patients should be able to demonstrate good technique regarding the use of each aerosol device that they are expected to use in self-care. Practitioner demonstration followed by repeated pa-tient return demonstration is a must, and should be reviewed frequently, such as with each of-fice/clinic visit.

Answer to Question 2

ANS: C
If these strategies fail to provide relief, continuous bronchodilator therapy (CBT) with nebulized albuterol doses ranging from 5 to 20 mg/hr have proved safe and effective for both adult and pe-diatric patients.