A nurse is preparing to obtain a sputum specimen for a client. Which of the following actions should the nurse plan to take?

A. The spacer increases the amount of medication delivered to the oropharynx.

Spacers are designed to minimize the amount of medication deposited in the oropharynx (back of the throat) and reduce the risk of side effects such as oral thrush or hoarseness. The main purpose of using a spacer is to optimize the delivery of medication to the lungs.

B. The spacer increases the amount of medication delivered to the lungs.

When reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma, the nurse should include the information that the spacer increases the amount of medication delivered to the lungs. Spacers help improve the delivery of medication from the MDI to the lungs by reducing the need for coordination between actuation of the MDI and inhalation. They also slow down the speed of the aerosolized medication particles, allowing more time for them to be inhaled into the lungs effectively.

C. Inhale rapidly when using the spacer with the MDI.

Inhaling rapidly may lead to improper inhalation technique and reduce the effectiveness of medication delivery to the lungs. Instead, the child should be instructed to inhale slowly and deeply to ensure that the medication reaches the lower airways.

D. Cover exhalation slots of the spacer with lips when inhaling.

Covering the exhalation slots of the spacer with lips during inhalation is not recommended. These slots are designed to allow the child to exhale freely and prevent buildup of pressure within the spacer. Encouraging the child to exhale into the spacer would hinder proper inhalation technique and could lead to decreased medication delivery to the lungs.

A. Start slowly and increase volume over several sessions.

This is the correct choice. For clients having difficulty using an incentive spirometer, starting slowly and gradually increasing the volume over several sessions is an appropriate approach. It allows the client to become familiar with the device and the technique required for effective use. Starting slowly also reduces the risk of discomfort or respiratory distress, allowing the client to build up their lung capacity gradually and achieve optimal results over time.

B. Do regular deep-breathing exercises instead.

Regular deep-breathing exercises are beneficial for improving lung function and respiratory strength. However, using an incentive spirometer serves a specific purpose in promoting deep breathing and lung expansion to prevent atelectasis (lung collapse) and improve respiratory function. While deep-breathing exercises are helpful, they may not provide the same targeted benefits as using an incentive spirometer, especially for clients who are experiencing difficulty with deep breathing or lung expansion.

C. Use another device because this one might be faulty.

This option assumes that the difficulty with the incentive spirometer is due to a fault in the device itself, which may not necessarily be the case. Before considering another device, it's important to ensure that the client is using the current device correctly and receiving proper instruction. If the client continues to have difficulty despite proper technique and instruction, then further assessment of the device may be warranted.

D. Be much more vigorous in increasing increments.

Being much more vigorous in increasing increments is not recommended, as it could lead to discomfort, respiratory distress, or hyperventilation for the client. Increasing the volume too quickly may overwhelm the client and make it more difficult for them to use the incentive spirometer effectively. Gradual progression allows the client to adjust to the device and build up their lung capacity safely and effectively over time.