Which principle(s) would be when teaching a patient to use a steroid inhaler? (Select all that apply.)
a. Frequent oral hygiene is necessary.
b. The inhaler should be used on a PRN basis only.
c. Rinse and spit after inhalation of the medication.
d. When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first.
e. Hold the breath for 10 seconds during inhalation of the medication.
ANS: A, C, D, E
Steroid medications may predispose patients to secondary fungal infections in the mouth. To prevent this, patients should be instructed on good oral hygiene technique and told to gargle and rinse the mouth with a hydrogen peroxide mouthwash after each aerosol treatment. In addition to good oral hygiene, patients should rinse and spit after inhalation of the medication. When a bronchodilator and steroid are prescribed, the bronchodilator should be administered as the first puff of medication and, after waiting a few minutes, the steroid medication should be administered. This procedure facilitates bronchodilation so that the second medication will have a better chance of reaching lower parts of the lungs. Patients should hold their breath for 10 seconds during inhalation of the medication so that the medication is fully inhaled. Steroid inhalers should be used on a regular basis to prevent symptoms.
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