A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
A.
Attaches spacer device to the inhaler.
B.
Stores the medication at room temperature.
C.
Primes the inhaler with 7 pumps.
D.
Rinses mouth after each use.
The Correct Answer and Explanation is :
The correct answer is:
C. Primes the inhaler with 7 pumps.
Explanation:
Ipratropium is a bronchodilator commonly prescribed to individuals with chronic obstructive pulmonary disease (COPD) to help open the airways, making it easier to breathe. This medication is typically administered through an inhaler, which requires proper technique to ensure effective use.
Why option C indicates additional teaching is needed: Priming an inhaler is essential to ensure that the device delivers the correct dose of medication. However, priming the inhaler with 7 pumps is incorrect and excessive. Typically, ipratropium inhalers require priming with 2 to 4 sprays when they are used for the first time or if they haven’t been used for an extended period (usually more than 3 days). Over-priming the inhaler (as indicated by 7 pumps) could result in wasting medication and could cause inaccurate dosing. Therefore, additional teaching is needed to educate the client on the correct priming technique to ensure proper drug administration.
Review of the other options:
- Option A: Attaching a spacer device to the inhaler is correct. A spacer helps deliver the medication more effectively into the lungs by slowing down the aerosol spray, allowing the client more time to inhale the medication deeply. This action does not indicate the need for additional teaching.
- Option B: Storing the medication at room temperature is appropriate. Ipratropium inhalers should be stored at room temperature (not too hot or cold), away from direct sunlight or extreme temperatures. This is proper care and does not warrant additional teaching.
- Option D: Rinsing the mouth after each use is recommended. Although ipratropium is not a steroid, rinsing the mouth after using any inhaler is a good habit. This practice helps reduce any unpleasant taste or dryness and prevents potential irritation from the medication. Therefore, this action is correct and does not require further education.
In summary, clients need clear instructions on the correct use of their inhalers, especially in regard to priming. Incorrect priming could lead to ineffective medication delivery, which may worsen symptoms in individuals with COPD.