Lecture on Administering Metered Dose Inhalers (MDI)

Introduction

• Perform Hand Hygiene: Essential before patient interaction.
• Ensure Privacy: Maintain patient confidentiality.
• Self-introduction to Patient: "Good morning, my name is Laurie, I'll be your nurse for today."
• Patient Identification: Use two identifiers and ask about allergies.

Understanding Metered Dose Inhalers

• Function: Delivers a measured dose of medication as aerosol spray/mist.
• Medication Check: Compare MDI label with Medication Administration Record (MAR) thrice, check expiration.
• Six Rights of Medication Administration: Ensure accuracy and safety.

Patient Assessment

• Respiratory Assessment: Check respirations and breath sounds.
• Patient Symptoms: Ask about subjective symptoms like shortness of breath.

Medication Education

• Purpose and Use: Explain the function of the medication and MDI.
• Usage Instructions: Caution against overuse and highlight potential side effects.

Using an Inhaler without a Spacer

• Preparation: Shake inhaler 5-6 times, remove mouthpiece cover.
• Positioning:
  • In mouth: Best delivery without spacer.
  • 2-4 cm in front: Alternative method.
• Inhalation Technique: Inhale slowly for 3-5 seconds, hold for 10 seconds, exhale slowly.

Using an Inhaler with a Spacer

• Preparation: Remove mouthpiece covers, insert inhaler into spacer, shake.
• Breathing Technique: Breathe normally through mouthpiece, release one puff, inhale slowly.
• Timing Between Doses: 20-30 seconds between same medication, 2-5 minutes between different medications.

Aftercare

• Mouth Rinse: Rinse with warm water two minutes post-inhalation.
• Cleaning the Inhaler: Remove canister, clean with water, air dry.
• Dose Tracking: Mark first use date, calculate doses (e.g., 200 puffs/canister, 6 puffs/day = 33 days).

Follow-up and Documentation

• Post-medication Assessment: Reassess respirations and breath sounds.
• Patient Demonstration: Encourage self-administration practice, provide feedback.
• Documentation: Record medication in MAR post-administration, note patient's response and outcomes.