The nurse is teaching a patient how to use a metered-dose inhaler without a spacer. Which action by the patient demonstrates correct use of the device?
a. Being careful not to shake the canister
b. Positioning the mouthpiece in front of the mouth while not touching the lips
c. Depressing the canister fully, waiting 3 to 5 seconds, then inhaling slowly and deeply
d. Taking another puff of the medication within 10 seconds
B
The best way to deliver medication without a spacer is to position the mouthpiece 2 to 4 cm in front of a widely opened mouth with the opening of the inhaler toward the back of the throat. The lips should not touch the inhaler. Shaking the inhaler before administration is the correct procedure; it mixes the medication within the canister. The correct procedure is to depress the canister fully while inhaling slowly and deeply through the mouth for 3 to 5 seconds. A wait of 20 to 30 seconds is advised between doses of the same medication; 2 to 5 minutes is the standard time between doses of different medications.
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