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NCLEX · General

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

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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