A nurse is teaching a client who has asthma about the use of a metered-dose inhaler. Which of the following instructions should the nurse Include In the teaching?

"Hold your breath for 6 seconds after inhaling the medication."

"Inhale the medication deeply for 5 seconds."

"Do not shake the medication in the inhaler."

"Hold the inhaler 3 inches away from your mouth."

Answer and Explanation

The Correct Answer is B

A. "Hold your breath for 6 seconds after inhaling the medication." – The correct recommendation is to hold the breath for at least 10 seconds to allow maximum medication absorption in the lungs.

B. "Inhale the medication deeply for 5 seconds." – A slow, deep inhalation (3-5 seconds) allows the medication to reach the lower airways effectively.

C. "Do not shake the medication in the inhaler." – Most metered-dose inhalers (MDIs) need to be shaken before use to ensure proper mixing of medication. Exceptions include dry powder inhalers (DPIs), which should not be shaken.

D. "Hold the inhaler 3 inches away from your mouth." – The correct distance is 1 to 2 inches (2-4 cm) from the mouth, or the mouthpiece can be placed directly into the mouth with lips sealed around it.

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Correct Answer is B

Explanation

A. Ask the client to tilt their head back when swallowing. Tilting the head back increases the risk of aspiration by opening the airway. Instead, the "chin tuck" method is recommended.

B. Have the client sit upright for 1 hr following meals. Sitting upright for an extended period reduces the risk of aspiration by allowing gravity to assist in digestion.

C. Administer liquids to the client using a syringe. Using a syringe can increase the risk of aspiration and does not allow the client to control swallowing.

D. Allow the client to rest for 10 min prior to eating. While rest may help conserve energy, it is not a priority intervention for dysphagia management.

A. Provide the client with a referral to a support group. B. Encourage the client to view the body of their partner. C. Reinforce the need for the client to build new relationships. D. Encourage the client to share their thoughts and feelings.

Correct Answer is D

Explanation

A. Provide the client with a referral to a support group. Not the first priority; occurs later in the grieving process.

B. Encourage the client to view the body of their partner. Only appropriate if the client wants to do so.

C. Reinforce the need for the client to build new relationships. Insensitive and premature during initial grief.

D. Encourage the client to share their thoughts and feelings. Therapeutic communication is the first step in grief support, allowing the client to process emotions.

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