The nurse prepares to complete a bedside urinalysis. Which step should the nurse plan to perform?

Rationale:
A. The statement that medication is delivered more quickly with a spacer is incorrect. A spacer does not speed up delivery; rather, it improves the efficiency of inhalation by allowing the medication to be inhaled slowly and deeply.

B. A spacer is not required for every person using a metered-dose inhaler (MDI). While beneficial, some clients can use an MDI effectively without a spacer if proper technique is mastered.

C. Using a spacer does not eliminate the need to wait between puffs. Proper timing between puffs is still necessary to allow the medication to work effectively in the lungs.

D. The correct response is that the spacer allows the client to inhale the medication more slowly and deeply. This improves delivery of the medication to the lower airways, reduces deposition in the mouth and throat, enhances therapeutic effectiveness, and can decrease local side effects such as irritation or oral candidiasis.

Rationale:
A. While a client’s preference to take medications at a different time is important for adherence, it does not directly impact the ability to safely self-administer oral medications. Scheduling can often be adjusted under the nurse’s guidance.

B. Mild nausea after taking medication is an adverse effect to monitor, but it may not prevent the client from taking medications safely. It can often be managed with supportive measures or timing adjustments.

C. Needing help reading medication labels is a barrier that can be addressed with large-print labels, medication organizers, or caregiver assistance. While it affects independence, it does not inherently prevent safe medication ingestion.

D. Difficulty swallowing pills and tablets is the most critical finding when assessing the ability to self-administer oral medications. This can directly compromise safety by causing choking, aspiration, or incomplete dosing. Identifying this issue allows the nurse to implement alternative strategies, such as using liquid formulations, pill crushers, or other administration techniques, to ensure the client receives the full prescribed dose safely.