A nurse is teaching a client who has asthma about how to use a metered-dose inhaler with a spacer. Which of the following information should the nurse include in the teaching?

"Clean the spacer daily with cold water."

"Hold your breath for 10 seconds once you inhale."

"Wait 30 seconds between puffs."

"The spacer should make a whistling sound as you inhale."

Answer and Explanation

The Correct Answer is B

A) "Clean the spacer daily with cold water": While it is important to clean the spacer regularly to prevent bacterial growth, the recommendation is usually to clean it weekly with warm, soapy water rather than daily with cold water. This detail is essential for effective use but not the most critical point during initial teaching.

B) "Hold your breath for 10 seconds once you inhale": This statement is key to ensuring effective medication delivery. Holding the breath for about 10 seconds allows the medication to settle in the lungs, maximizing its therapeutic effects. This information is crucial for the client to understand the proper technique for using the inhaler with a spacer.

C) "Wait 30 seconds between puffs": While it is advisable to wait for a brief period between puffs to allow the first dose to be effective, the recommended wait time is generally around 1 minute, particularly if using a different medication or if instructed by the healthcare provider. Therefore, stating 30 seconds may be misleading.

D) "The spacer should make a whistling sound as you inhale": A whistling sound during inhalation may indicate that the spacer is being used incorrectly or that the client is inhaling too forcefully. The absence of a whistling sound is often a sign of proper technique. Therefore, this statement is misleading and not appropriate teaching for effective inhaler use.

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Correct Answer is A

Explanation

A) Internal fixation of a fractured hip. This procedure is associated with a higher risk of fat embolism syndrome (FES) due to the release of fat globules from the bone marrow into the bloodstream following trauma or surgery to long bones. The likelihood increases after orthopedic surgeries, especially in the hip and pelvis regions, where bone marrow is rich. Recognizing this risk is critical for monitoring and early intervention.

B) Repair of a torn rotator cuff. While this procedure involves surgery on the shoulder, it is not typically associated with a significant risk of fat embolism. The shoulder region does not contain the same volume of fatty tissue or bone marrow as the hip, making this option less likely to contribute to FES.

C) Thyroidectomy. This procedure is primarily focused on the thyroid gland in the neck and does not involve manipulation of large bones or fatty tissues, thus posing a minimal risk for fat embolism syndrome. It is more related to complications like hypoparathyroidism or nerve injury rather than fat embolism.

D) Tympanoplasty. This ear surgery involves repairing the eardrum and does not present a risk for fat embolism. The procedure is localized and does not involve significant manipulation of fatty tissues or large bones, making it unlikely to contribute to FES.

A. Remind the client of the importance of medication adherence. B. Tell the client to avoid places where there are large crowds of people. C. Initiate a referral for the client to a home health agency. D. Instruct the client to avoid eating raw vegetables.

Correct Answer is C

Explanation

A) Remind the client of the importance of medication adherence.: While emphasizing medication adherence is important, it does not directly advocate for the client's needs related to self-care at home. It is more of a standard teaching point rather than a specific action to support the client's independence.

B) Tell the client to avoid places where there are large crowds of people.: Advising the client to avoid crowded places is a precaution to prevent infection, but it does not empower the client or help them maintain their self-care abilities. Advocacy involves supporting the client's choices and helping them navigate their circumstances.
C) Initiate a referral for the client to a home health agency.: This action demonstrates client advocacy by actively seeking resources that can provide the client with the support they need to manage their care at home. A home health agency can offer assistance with medication management, monitoring health status, and providing companionship, which aligns with the client's goal of self-care while living alone.

D) Instruct the client to avoid eating raw vegetables.: While this is a valid dietary recommendation for someone with a compromised immune system, it does not specifically advocate for the client’s self-care or independence. It is a preventive measure rather than a supportive action that empowers the client.

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A nurse is teaching a client who has asthma about how to use a metered-dose inhaler with a spacer. Which of the following information should the nurse include in the teaching?

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