100%(1)1 out of 1 people found this document helpful
This preview shows page 95 - 99 out of 108 pages.
May need supplemental O2May need artificial ventilation Drug therapy
Long actingoDaily maintenanceGoal is to prevent attacks oInhaled steroidsoOral steroidsoSystemic corticosteroids (Prednisone)oAnti-IgEoBronchodilators oLeukotriene modifiers oAdvairoSymbicort oDo NOT use in acute attack Short acting oRescue inhaler oSABACommon side effect = tremors (ok)oInhaled anticholinergic?oBronchodilatorsoUSING AN INHALER (MDI)Know the stepsKnow what is proper vs improperKnow whyKnow when to replaceKnow how to clean Education is keyHave the pt demonstrate If medications are not used correctlyMedication is less effective because most of the medication does not get into the lungs STEPSCheck with book 1.Take off cap and shake inhaler 2.Hold upright 3.Have pt breathe all the way out 4.Hold in the way told by the doctora.1-2 in away from the mouth b.Using a spacerc.Directly in the mouthd.Depends on order5.If spacer a.Press down on inhaler
b.Breathe in slowly through mouth within 5 sec 6.If no spacer a.Breathe in slowlythrough mouthb.While breathing in slowly -> thenpress down on inhaler one timec.Must start breathing in before then press the inhaler7.Keep breathing in slowly and as deeply as possible8.Hold breath for 10 sec 9.Slowly exhale10.May repeat after 1 minute if need another puffa.Some meds you can do 2 puffs back to backb.Depends on med 11.Rinse out mouth aftera.To prevent fungal infections in mouthWhen to clean inhaler 1.If powder around hole where medicine sprays out How to clean inhalerRemove metal canister from L-shaped plastic mouthpieceRinse only the mouthpiece and cap in warm waterLet dry overnightPut canister pack in, in morningPut cap on When to replace inhaler Very important so don’t run out of medicationKnow how many puffs in canisterKnow how many puffs take per dayEx.200 puffs in canister8 puffs per day= med will last 25 daysput note in calendar to go get new med at 20 days!Dry Powdered Inhaler (DPI)1.Check for dust/ dirt 2.May be held upright or horizontal 3.Do not shake4.Tilt head back and exhale all air prior to putting device in mouth 5.Breathe in deeply and quickly 6.Hold breath 10 sec or as long as can7.Do not use this in humid placeShower room
Simpler than MDIDelivered only by inspiratory effort so not good for patients with low FEVComparison of Metered-Dose and Dry Powder InhalersMetered-Dose Inhaler (MDI)*Dry Powder Inhaler(DPI)Shake before useMay be needed for some (e.g., albuterol), but not for others (Read package insert)NoInspirationSlowRapidSpacerMay be used with inhaled corticosteroids or for more effective delivery (Read package insert)None permittedCounting deviceMany have an external device, but some do notMost preloaded forms include counterInhalations/doseOften 2/doseOften 1/doseCleaningUse water for plastic caseAvoid moistureNursing careEducation Prevention of attacksMed useIdentify and then avoid triggers