Administration should include following procedures for the use of handheld inhalers (i.e., metered dose):
- Provide for client privacy and explain the procedure.
- Verify the medication order for accuracy with the MAR and read the label three times.
- Date and initial multi-use containers when opened.
- Wash your hands.
- Put on gloves if there is any body fluid contact.
- Warm the canister by rolling between your hands.
- Remove the cap and hold the inhaler upright.
- If using the inhaler for the first time or after a prolonged period of time, test it by spraying into the air before spraying into the mouth.
- Have the client take a drink of water to moisten the mouth.
- Position the inhaler with the mouthpiece between the lips and pursed to make a seal around the mouthpiece.
- Instruct the client to hold his/her breath for 10 seconds to allow the medication to penetrate deeply into the lungs and then slowly exhale through the nose.
- If additional puffs are ordered, wait at least one minute and then repeat the previous three steps.
- Rinse mouth after steroid inhaler.
- Replace the inhaler cap and store the inhaler per facility policy.
- Remove and properly dispose of gloves, if worn, and wash your hands.
- Document administration according to facility policy.
Note: Metered-dose inhalers should be cleaned at least weekly by removing the metal canister, rinsing the holding device under warm running water, and allowing it to air dry thoroughly.
Note: Read the instructions that accompany the inhaler to ensure the correct procedure is followed.
Process/Skill Questions:
- Where should the reusable nebulizer equipment be stored?
- How often should tubing be changed?