A nurse is teaching a client who has asthma how to use a metered-dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. (Move the steps, placing them in the selected order of performance. Use all steps.)

A. Insomnia is not a common side effect of rifampin. While individual responses to medications can vary, the typical side effects of rifampin do not generally include sleep disturbances. More common side effects include gastrointestinal upset, rash, and liver enzyme changes.
B. The treatment duration for rifampin in the context of active tuberculosis is typically much longer than 1 month. Standard therapy often lasts for at least 6 months and may vary depending on the specific treatment regimen and patient response.
C. Rifampin is generally recommended to be taken on an empty stomach, either 1 hour before or 2 hours after meals, to enhance absorption. Taking it with food may reduce its effectiveness. This information is crucial for ensuring the medication works optimally.
D. One of the notable side effects of rifampin is that it can cause urine, sweat, tears, and other bodily secretions to turn a reddish-orange color. This is harmless but important for the patient to be aware of, as it can cause concern or confusion regarding potential blood in urine or other secretions.

F. Inhale deeply and then exhale completely: This ensures that the airways are clear before inhaling the medication.
D. Place her lips firmly around the mouthpiece: A tight seal around the mouthpiece is important to prevent the medication from escaping and to ensure that it reaches the lungs.
A. Breathe in deeply over 2 to 3 seconds while pushing down on the canister: This action releases the medication into the lungs. It's important to inhale slowly and deeply to maximize the delivery of the medication.
G. Hold her breath for 10 seconds: Holding the breath allows the medication to settle into the lungs, increasing its effectiveness.
E. Exhale slowly through pursed lips: Exhaling slowly helps to prevent the medication from being exhaled too quickly and reduces the risk of irritation to the airways.
C. Wait 60 seconds between each puff: If more than one puff is prescribed, waiting 60 seconds between puffs allows the medication from the first puff to settle into the lungs before inhaling the second puff.