What should the nurse recommend to improve delivery of medication with a metered-dose inhaler for Mr. Lewis?

What should the nurse recommend to improve delivery of medication with a metered-dose inhaler for Mr. Lewis?

• A. A spacer used with the MDI is easier to use and will provide better delivery of medication to his airway.
• B. He should consult with the pharmacist about taking his medications in a form other than the inhaled route.
• C. There are oral forms of the medications that are just as effective and easier for him to take.
• D. He will need to be re-educated in the use of inhaled medications.

Answer: (A)

The main concept is that a spacer improves how well inhaled medications reach the lungs. A metered-dose inhaler requires good coordination between pressing the canister and inhaling, and many people, especially if they have limited dexterity or lung function, don’t inhale at the right moment. A spacer acts as a reservoir, slowing and dispersing the spray so the patient can take a deeper, slower inhalation and inhale more of the medication. This increases the amount reaching the airways and reduces the amount deposited in the mouth and throat, which also lowers local irritation and side effects from inhaled steroids. For Mr. Lewis, using a spacer with the inhaler will provide better delivery of the medication to the airways. To use it effectively, he should activate the inhaler into the spacer, exhale fully, place his lips around the mouthpiece, then inhale slowly and deeply while pressing the canister, and hold his breath for about 5–10 seconds before exhaling. Other options are less fitting because changing the route or using an oral form may not provide the same targeted lung effect, and while re-education is helpful, the spacer directly enhances delivery efficiency.

The main concept is that a spacer improves how well inhaled medications reach the lungs. A metered-dose inhaler requires good coordination between pressing the canister and inhaling, and many people, especially if they have limited dexterity or lung function, don’t inhale at the right moment. A spacer acts as a reservoir, slowing and dispersing the spray so the patient can take a deeper, slower inhalation and inhale more of the medication. This increases the amount reaching the airways and reduces the amount deposited in the mouth and throat, which also lowers local irritation and side effects from inhaled steroids. For Mr. Lewis, using a spacer with the inhaler will provide better delivery of the medication to the airways.

To use it effectively, he should activate the inhaler into the spacer, exhale fully, place his lips around the mouthpiece, then inhale slowly and deeply while pressing the canister, and hold his breath for about 5–10 seconds before exhaling. Other options are less fitting because changing the route or using an oral form may not provide the same targeted lung effect, and while re-education is helpful, the spacer directly enhances delivery efficiency.