Administering Metered Dose Inhaler Medication

Administering Metered Dose Inhaler Medication

Equipment
■ MDI.
■ Spacer.
■ Tissues.

Assessment
■ Assess respiratory status before administration of medication to establish a baseline for evaluating the effects of treatment.

Post-Procedure Reassessment
■ Be Safe! Assess for change in respiratory status, including VS, and oxygen saturation.

Key Points
■ Be Smart! Identify the number of remaining inhalations in the canister. The “float method” is no longer recommended for determining whether an MDI canister is empty.
■ Shake the inhaler. Remove the mouthpiece cap of the inhaler and
insert the mouthpiece into the spacer while holding the canister upright.
■ Remove the cap from the spacer.
■ Ask the patient to breathe out slowly and completely.
■ If the patient is unable to use the MDI independently, time the use of the device with the patient’s respirations.
■ Place the spacer mouthpiece into the patient’s mouth and ask him to seal his lips around the mouthpiece. Press down on the inhaler canister to discharge one puff of medication into the spacer.
■ Ask the patient to slowly inhale through the nose; then hold his breath for as long as possible.
■ If a second puff is needed, wait at least 1 minute and repeat.

Documentation
■ Chart scheduled medications in the MAR.
■ Chart PRN medications in the nursing notes, including reason given and response.
■ Record medication, time, dose, and route given; therapeutic and adverse drug effects, nursing interventions, and teaching.
■ Document assessment data before, during, and after instillation.

Step 1: Shake the canister

Step 2: Remove cap. Discharge 2 puffs

Step 3: Deep breath out

Step 4: Press top. Inhale medication slowly

Step 5: Hold breath. Exhale slowly

Step 6: Remove inhaler from mouth. Wait 1 minute before next puff