A patient with asthma will be using a metered-dose inhaler (MDI) ...

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A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that:
 
  a. a chlorofluorocarbon (CFC) propellant is superior to a hydrofluoroalkane (HFA) propellant.
  b. the patient should activate the device and then inhale.
  c. the patient should store the MDI in the refrigerator between doses.
  d. the patient should wait 1 minute between puffs.

Question 2

A patient who takes teriparatide (Forteo) administers it subcutaneously with a prefilled pen injector. The patient asks why she must use a new pen every 28 days when there are doses left in the syringe. Which is the correct response by the nurse?
 
  a. Go ahead and use the remaining drug; I know it is so expensive.
  b. The drug may not be stable after 28 days.
  c. You are probably not giving the drug accurately.
  d. You should be giving the drug more frequently.

[juliaf]

Answer to Question 1

ANS: D
When 2 puffs are needed, an interval of at least 1 minute should separate the first puff from the second. CFC propellants will be discontinued because of damage to the environment. The patient should begin inhaling and then activate the device. There is no need to store the drug in the refrigerator.

Answer to Question 2

ANS: B
Teriparatide is supplied in 3-mL injectors. The pen should be stored in the refrigerator and discarded after 28 days, even if some drug remains in the syringe. Although the drug is expensive, it is not correct to use what is in the syringe after 28 days. Drug may be left in the syringe even with correct dosing.

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