A client with degenerative arthritis is provided with a spacer along with a corticosteroid metered-dose inhaler. The nurse recognizes that the spacer assists this client to:

Question

1. compensate for decreased dexterity.
2. use a larger dose of the steroid.
3. progress with weaning from the steroid drug.
4. avoid thrush infections.

Answer 1

Correct Answer: 1
Rationale 1: Spacers allow the client with decreased mobility or poor coordination to use a metered-dose inhaler more effectively.
Rationale 2: The dose of the drug is not affected.
Rationale 3: Weaning from the steroid is not affected.
Rationale 4: Thrush infection of the throat can still be an issue if the client does not rinse the mouth after using the steroid.
Global Rationale: To decrease oropharyngeal deposition and to enhance drug delivery to the lungs, many health care providers recommend that patients use a spacer with their MDI. A spacer is a special tube that attaches to the mouthpiece that is designed to hold the cloud of aerosolized medication. This serves two primary purposes. First, the spacer holds drops that fall out of the aerosol so that less medication is deposited on the oropharynx and in the mouth. Second, because the spacer holds the medication, the patient does not have to precisely coordinate inhalation with activation, so that more drug reaches the site of action. Drug dose and ease of weaning are not affected. Thrush may occur.