A client is learning metered-dose inhaler technique. The client ...

[NguyenJ]

A client is learning metered-dose inhaler technique. The client says, I don't understand why I have to use this thing. Can't I just take pills? The nurse responds that the inhalation route:
 
  1. is easier to master than is oral therapy.
  2. is less expensive than is oral therapy.
  3. is more likely to lead to termination of the disease process than are pills.
  4. delivers the medication directly to the site, resulting in lower doses and fewer systemic side effects.

Question 2

A client with degenerative arthritis is provided with a spacer along with a corticosteroid metered-dose inhaler. The nurse recognizes that the spacer assists this client to:
 
  1. compensate for decreased dexterity.
  2. use a larger dose of the steroid.
  3. progress with weaning from the steroid drug.
  4. avoid thrush infections.

[jessofishing]

Answer to Question 1

Correct Answer: 4
Rationale 1: Greater manual dexterity is required to master an inhaler or other device than to take pills.
Rationale 2: There is considerable expense involved with some inhalers.
Rationale 3: These drugs are used to control pulmonary problems; they are not curative.
Rationale 4: The inhaled route delivers the drug directly to the lungs, so lower doses are possible and there are fewer systemic side effects than are typically associated with pills.
Global Rationale: By inhaling during drug delivery, the patient helps to ensure that the drug reaches the site of action in the lungs. Use of a spacer enhances this delivery. Using an inhaler requires more manual dexterity than does taking a pill orally, can be considerably expensive, and is not a curative intervention.

Answer to Question 2

Correct Answer: 1
Rationale 1: Spacers allow the client with decreased mobility or poor coordination to use a metered-dose inhaler more effectively.
Rationale 2: The dose of the drug is not affected.
Rationale 3: Weaning from the steroid is not affected.
Rationale 4: Thrush infection of the throat can still be an issue if the client does not rinse the mouth after using the steroid.
Global Rationale: To decrease oropharyngeal deposition and to enhance drug delivery to the lungs, many health care providers recommend that patients use a spacer with their MDI. A spacer is a special tube that attaches to the mouthpiece that is designed to hold the cloud of aerosolized medication. This serves two primary purposes. First, the spacer holds drops that fall out of the aerosol so that less medication is deposited on the oropharynx and in the mouth. Second, because the spacer holds the medication, the patient does not have to precisely coordinate inhalation with activation, so that more drug reaches the site of action. Drug dose and ease of weaning are not affected. Thrush may occur.

[NguyenJ]

TYSM

[Kedrick2014]

Excellent