A patient with asthma is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler?
A. "After you inhale the medication once, repeat until you obtain symptomatic relief."
B. "Wait no longer than 30 seconds after the first puff before taking the second one."
C. "Use a spacer with the inhaler and rinse your mouth after each dose administration."
D. "Breathe in through the nose and hold for 2 seconds just before activating the inhaler."
Answer: C. "Use a spacer with the inhaler and rinse your mouth after each dose administration."
Explanation: Spacers are available for use with MDIs to prevent the patient from swallowing the dose and to allow for maximum delivery of medication to the lungs. Rinsing the mouth after administration is important for inhaled glucocorticoids to prevent candidiasis. Glucocorticoid inhalers are used for long-term prophylaxis of asthma, not for symptomatic relief. When two puffs are needed, an interval of at least 1 minute should separate the first puff from the second. Inhaling through the mouth just before activating the MDI is the proper technique.
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