Over the course of treatment for chronic asthma, a client develops an allergy to the propellants in rapid-acting metered-dose inhalers (MDI). What option would the nurse expect to be used to address this problem after discharge?

Question

1. Oral medication of the same class as the metered-dose inhaler
2. Nebulizer treatments
3. A concentrated-dose metered-dose inhaler
4. A dry powder inhaler (DPI)

Answer 1

Correct Answer: 4
Rationale 1: Oral medications would increase the systemic side effects and do not have a rapid onset for rescue.
Rationale 2: Nebulizer treatments are not portable enough for daily use, take 30 minutes to deliver the medication, and are not recommended when rapid action is required.
Rationale 3: The MDI is no longer an option because the client is experiencing difficulty with the propellants.
Rationale 4: Dry powder inhalers contain no propellants.
Global Rationale: The DPI has no propellants in the canister and is activated simply by inhalation. Oral medications would increase the systemic side effects and, like nebulizers, do not have a rapid onset for rescue. The MDI is no longer an option because the client is experiencing difficulty with the propellants.