The client who regularly uses a metered-dose inhaler four times a day tells the nurse that it is difficult to tell when the canister is empty. What instruction should the nurse give this client?
1. Place the canister in a bowl of water. If the canister floats, it is not empty.
2. When you get a new canister, divide the number of puffs that is listed on the label by four. That will tell you how many days the canister will last.
3. You can tell that the canister is empty when you can no longer smell the medication when you activate the plunger.
4. When you feel like you are no longer getting maximum effect from the medication, your canister is empty.
Correct Answer: 2
Rationale 1: The old method of floating the canister in water is not accurate as there may be propellant left in the canister after the medication is all dispensed.
Rationale 2: The best way to track the number of puffs left in a canister is to start with the new canister, dividing the number of puffs listed on the label by the number of puffs taken each day.
Rationale 3: Being able to smell the medication is not an indication of the amount left in the canister.
Rationale 4: Waiting until there is lack of maximum effect from the medication may put the client at risk for respirator illness exacerbation.
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