A nurse is preparing to administer a metered dose inhaler (MDI) medication to a client. Which of the following actions should the nurse take?

Ask the client to inhale the medication quickly for 1 second.

Ask the client to hold their breath for 2 seconds after inhalation.

Shake the MDI prior to administration.

Wash the MDI canister in warm water after each use.

Answer and Explanation

The Correct Answer is C

A) Ask the client to inhale the medication quickly for 1 second:
The client should inhale the medication slowly and deeply, not quickly. A rapid inhalation can reduce the effectiveness of the medication as it may not reach the deeper parts of the lungs effectively.

B) Ask the client to hold their breath for 2 seconds after inhalation:
The client should hold their breath for about 10 seconds after inhalation to allow the medication to settle in the lungs and be absorbed. Holding the breath for just 2 seconds is typically insufficient for optimal medication delivery.

C) Shake the MDI prior to administration:
Shaking the MDI before use is important to ensure that the medication is properly mixed and delivered in the correct dose. Failure to shake the MDI can result in an uneven distribution of medication.

D) Wash the MDI canister in warm water after each use:
The MDI canister should not be washed frequently, as this can affect the device's function and lead to potential contamination. The canister should be cleaned as per the manufacturer’s instructions, typically every few days or as needed.

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Correct Answer is B

Explanation

A) The client wears fitted slippers:
Fitted slippers generally provide good support and are less likely to contribute to falls compared to loose or ill-fitting footwear. Therefore, this finding is less likely to be a major contributor to the client’s falls.

B) The client takes alprazolam:
Alprazolam is a benzodiazepine that can cause sedation, dizziness, and impaired coordination. These side effects can significantly increase the risk of falls, especially in older adults. Thus, this medication is a likely contributor to the client's falls.

C) The client has a nonslip bath mat in his shower:
A nonslip bath mat is a safety measure designed to prevent falls in the shower. Its presence suggests a proactive approach to reducing fall risk, so it is less likely to be contributing to the problem.

D) The client uses a raised toilet seat:
A raised toilet seat can be a helpful adaptation for individuals with mobility issues, making it easier to sit down and stand up. It is generally not associated with an increased risk of falls, so this finding is unlikely to be contributing to the client’s falls.

A. "Crushing the medication is a good idea, and I can mix it in some ice cream for you." B. "Crushing the medication might cause you to have a stomachache or indigestion." C. "Crushing the medication would release all the medication at once, rather than over time." D. "Crushing is unsafe, as it destroys the ingredients in the medication."

Correct Answer is C

Explanation

A) "Crushing the medication is a good idea, and I can mix it in some ice cream for you."
Crushing enteric-coated medications is not advisable as it can disrupt the medication’s intended release mechanism. Enteric coatings are designed to protect the stomach lining and ensure that the medication is released in the intestines. Crushing the medication would bypass these protective mechanisms.

B) "Crushing the medication might cause you to have a stomachache or indigestion."
While this statement is somewhat true, it does not fully address the primary concern. Enteric-coated medications are designed to protect the stomach lining and to ensure proper absorption. Crushing them could lead to other issues beyond just stomachache or indigestion.

C) "Crushing the medication would release all the medication at once, rather than over time."
This is the most accurate response. Enteric-coated aspirin is designed to dissolve in the intestines rather than the stomach, and crushing it would lead to the medication being released all at once, which could potentially cause irritation or harm to the stomach and reduce the medication's effectiveness.

D) "Crushing is unsafe, as it destroys the ingredients in the medication."
While crushing enteric-coated medications can be unsafe, the primary issue is not the destruction of the ingredients but the loss of the medication’s intended release mechanism. This can result in adverse effects or reduced efficacy.

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A nurse is preparing to administer a metered dose inhaler (MDI) medication to a client. Which of the following actions should the nurse take?

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