NCLEX · Physiological Adaptation

A nurse is teaching a client how to use a metered-dose inhaler (MDI) with a bronchodilator and a corticosteroid inhaler. Which instruction is correct?

Correct answer

Use the bronchodilator first, wait a few minutes, then use the corticosteroid; rinse the mouth after the corticosteroid

  1. A Use both at the exact same time
  2. B Use the corticosteroid first
  3. C Use the bronchodilator first, wait a few minutes, then use the corticosteroid; rinse the mouth after the corticosteroid
  4. D Never rinse the mouth

Why this is the answer

When using both a BRONCHODILATOR and a CORTICOSTEROID inhaler, use the BRONCHODILATOR FIRST (it opens the airways), wait a few minutes, THEN use the corticosteroid (so it reaches deeper into the now-open airways). NCLEX physiological/respiratory. RINSE THE MOUTH after using the CORTICOSTEROID inhaler to prevent oral thrush (candidiasis), a common side effect of inhaled steroids. MDI technique: shake, exhale, seal lips, press and inhale slowly/deeply, hold breath ~10 seconds; use a spacer if available; wait between puffs. Knowing the order (bronchodilator first) and rinsing the mouth after corticosteroids are commonly tested inhaler-teaching points.
Source: NCLEX Physiological — Inhaler Administration

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About this topic: Physiological Adaptation

Physiological adaptation questions cover acute and chronic illness management, hemodynamics, medical emergencies, unexpected responses to therapy, and the priority nursing actions in each. This is one of 15 RN: Physiological Integrity questions on physiological adaptation, each with a full explanation on a single study page.

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