Nurse Teachings on Inhalers

Patient/caregiver was educated on the process steps to use spacer with inhaler as below:

  1. Remove the cap from your inhaler, and from your spacer, if it has one
  2. Shake the inhaler well before use (3-4 shakes)
  3. Put the inhaler into the spacer
  4. Always, check the expiration date on the inhaler before using it.
  5. Shake the inhaler well for 5 seconds before every use.
  6. Take the cap off the mouthpiece of the inhaler
  7. Hold the inhaler between the thumb at the base and the index finger at the top, with the canister up and mouthpiece down.
  8. Make sure the mouthpiece of the inhaler is clean before inserting it into the spacer.
  9. Insert the mouthpiece of the inhaler into the spacer.
  10. Make sure the mouthpiece of spacer is facing you and is clean before inserting it in the mouth.
  11. Perform a normal quiet breathing in and then, breath out normally away the inhaler.
  12. Bring the inhaler to your mouth and place the mouthpiece of the spacer in between the teeth with the chin up a little. This position of the chin will help better deposition of the medication into the airways.
  13. Make sure the tongue is not obstructing the mouthpiece of the spacer, by having the mouthpiece over the tongue and not under.
  14. Close the mouth tightly around the mouthpiece.
  15. Breath in slow and deep for a complete breath, for a count of 5 seconds. At the same time, activate the inhaler by pressing the top of the inhaler with the index finger. Performing both these acts at the same time is a task that will help delivery of the medication to the site of action in the airways and lungs.
  16. One activation of the inhaler counts for one puff.
  17. Hold breath for 5 – 10 seconds giving time for the medication to be deposited into the airways, for it to act.
  18. Withdraw the mouthpiece from your mouth and breath out slowly.
  19. If you are ordered to have two puffs as your dose, wait for a minute before taking the second puff.
  20. For the second puff, start with shaking the inhaler for 5 seconds and repeating all the steps of the procedure throughout.
  21. Detach the spacer from the inhaler and replace the cap on the inhaler.

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