An asthmatic patient has right-sided paralysis caused by a stroke ...

[lb_gilbert]

An asthmatic patient has right-sided paralysis caused by a stroke 3 years ago. The prescriber orders an inhaler. Which type of inhaled device would the nurse expect to be ordered for this patient?
 
  a. Inhaler without a spacer
  b. Dry-powder inhaler
  c. Glucocorticoid
  d. Nebulizer

Question 2

The nurse has received an order for an asthmatic patient for a metered-dose inhaler (MDI), 2 puffs BID. While instructing the asthmatic patient in the proper use of an MDI, the nurse should include which of the following instructions?
 
  a. Inhale after activating the device.
  b. Administer 2 puffs, wait 1 minute, and administer 2 more.
  c. Wait 1 minute between the first and second puff.
  d. Puff the inhaled doses in rapid succession.

[wshriver]

Answer to Question 1

ANS: B
Dry powder inhalers are breath activated and do not require the hand-lung coordination needed with MDIs. They would be easier for a patient with hemiparesis to use.
Use of an MDI requires hand-lung coordination and would not be the best choice for a patient with hemiparesis.
A glucocorticoid is not necessarily an inhaled device.
A nebulizer must be set up and would be more difficult for a patient with hemiparesis.

Answer to Question 2

ANS: C
When 2 puffs are needed, an interval of at least 1 minute should separate the first puff from the second.
The inhale should be just prior to activation of the device.
If the medication is ordered 2 puffs BID, the patient would not administer 2 puffs followed by 2 more puffs in 1 minute.
There should be at least a 1 minute interval between puffs. They should not be taken in rapid succession.

[lb_gilbert]

TY

[wshriver]

You're welcome