A nurse is caring for a client receiving oral corticosteroid therapy. Which of the following assessments should the nurse prioritize?

A) Correct. Metered-dose inhalers (MDIs) require the client to coordinate their breathing with inhalation. They release a measured dose of medication in aerosol form, and the client needs to inhale deeply at the same time to ensure the medication reaches the lungs. Dry powder inhalers (DPIs), on the other hand, do not require coordination of breathing and inhalation. The client simply needs to inhale forcefully to activate the powder dispersion.

B) Incorrect. MDIs contain a propellant that helps atomize the medication and facilitate its delivery into the lungs, but this is not the main difference between MDIs and DPIs.

C) Incorrect. DPIs deliver the medication in powder form, not mist form.

D) Incorrect. DPIs do not require the use of a spacer device, unlike MDIs, which can benefit from a spacer device to improve medication delivery.

A) Correct. Instructing the client to rinse their mouth with water after each inhalation is important when using an inhaled corticosteroid. This action helps prevent the development of oral candidiasis (thrush), a potential side effect of inhaled corticosteroids.

B) Incorrect. Inhaled corticosteroids are maintenance medications for COPD and are not intended for use on an as-needed basis during acute exacerbations. Clients should have a separate rescue inhaler for acute symptom relief.

C) Incorrect. The use of a spacer device can improve the delivery of inhaled corticosteroids to the lungs, especially for clients who have difficulty coordinating inhaler use. Therefore, it is recommended to use a spacer device when using an inhaler.

D) Incorrect. Inhaled corticosteroids provide long-term control of symptoms in COPD but do not provide immediate relief. It may take several days to weeks of consistent use for the medication to reach its full therapeutic effect.