Skill 39
Metered-Dose Inhalers
Pressurized metered-dose inhalers (pMDIs), breath-actuated metered-dose inhalers (BAIs), and dry powder inhalers (DPIs) deliver medications that produce local effects such as bronchodilation. Some of these medications are absorbed rapidly through the pulmonary circulation and create systemic side effects (e.g., albuterol [Proventil] may cause palpitations, tremors, and tachycardia). Patients who receive drugs by inhalation frequently suffer from asthma and chronic respiratory disease. Drugs administered by inhalation provide control of airway hyperactivity or constriction. Because patients depend on these medications for disease control, they must understand both how these medications work and how they are safely administered.
Delegation Considerations
The skill of administering MDIs cannot be delegated to nursing assistive personnel (NAP). The nurse directs the NAP about:
▪ Potential side effects of medications and to report their occurrence to the nurse.
▪ Reporting breathing difficulty (e.g., paroxysmal coughing, audible wheezing).
