A nurse is teaching a client who has asthma and a prescription for an inhaler. Which of the following instructions should the nurse include?

"Clean the canister and cap of the inhaler every 2 weeks."

"Wait 1 minute between puffs of the inhaler."

"Tilt your head forward and inhale rapidly while depressing the canister."

"Place your middle finger at the mouthpiece and your thumb at the top of the inhaler."

Answer and Explanation

The Correct Answer is B

A) "Clean the canister and cap of the inhaler every 2 weeks": While it's important to keep the inhaler clean, it should be cleaned more frequently than every 2 weeks. Typically, cleaning is recommended at least once a week to prevent medication buildup and ensure proper functioning.

B) "Wait 1 minute between puffs of the inhaler": Waiting 1 minute between puffs allows the medication from the first puff to take effect and opens the airways, making the second puff more effective. This practice helps maximize the medication's absorption and effectiveness.

C) "Tilt your head forward and inhale rapidly while depressing the canister": The correct technique involves tilting the head slightly back, not forward, to open the airways better. Additionally, the client should inhale slowly and deeply, rather than rapidly, to ensure the medication is properly delivered to the lungs.

D) "Place your middle finger at the mouthpiece and your thumb at the top of the inhaler": This description of finger placement is incorrect. The correct technique is to place the thumb at the base of the inhaler and the index and middle fingers on the top of the canister to allow for proper grip and activation of the inhaler.

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Correct Answer is C

Explanation

A) Metabolic alkalosis: Metabolic alkalosis is characterized by a high pH and elevated bicarbonate (HCO3). In this scenario, the pH is elevated at 7.6, which supports alkalosis, but the HCO3 level is normal at 24 mEq/L. The PaCO2 is slightly low, which is not typical for metabolic alkalosis, as it would usually show an elevated HCO3 with a compensatory respiratory alkalosis.

B) Respiratory acidosis: Respiratory acidosis would present with a low pH and an elevated PaCO2. In this case, the pH is high at 7.6, indicating alkalosis, and the PaCO2 is also low at 30 mm Hg, which is inconsistent with respiratory acidosis.

C) Respiratory alkalosis: Respiratory alkalosis is indicated by a high pH with a low PaCO2. Here, the pH is elevated at 7.6, and the PaCO2 is decreased at 30 mm Hg, which fits the profile of respiratory alkalosis. The normal HCO3 level suggests that the bicarbonate is not compensating, supporting a primary respiratory alkalosis.

D) Metabolic acidosis: Metabolic acidosis is characterized by a low pH and a low HCO3. In this scenario, the pH is elevated at 7.6, and the HCO3 level is normal at 24 mEq/L, which does not align with metabolic acidosis. The PaCO2 is also low, which is not typical for metabolic acidosis, as it would usually have a normal or high PaCO2.

A. "A parent is supposed to pass before their child." B. "My partner and I have plans to open a small business." C. "I have put all the pictures of my child in the attic." D. "My partner says I seem to forget things frequently."

Correct Answer is B

Explanation

A) "A parent is supposed to pass before their child": This statement reflects ongoing grief and a struggle with the loss, indicating the client is still grappling with the emotional impact rather than moving toward reorganization and acceptance.

B) "My partner and I have plans to open a small business": This statement demonstrates that the client is beginning to focus on future goals and engaging in activities that signify a return to normalcy and investment in life. This reflects reorganization and acceptance of the loss as they are planning for the future.

C) "I have put all the pictures of my child in the attic": Putting away pictures of the child might indicate avoidance or difficulty coping with reminders of the loss. This action suggests the client may still be in the process of dealing with grief rather than having reached acceptance.

D) "My partner says I seem to forget things frequently": Frequent forgetfulness can be a symptom of ongoing grief and emotional distress. This indicates that the client may still be experiencing significant emotional and cognitive impacts from the loss.

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A nurse is teaching a client who has asthma and a prescription for an inhaler. Which of the following instructions should the nurse include?

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