New ATI NCLEX style case scenario: metered-dose
inhalers Individual Project
Learning objectives:
1. Identify the action and nursing implications essential to administer metered-dose inhalers safely.
2. Discuss what nursing actions are a priority if an adverse reaction occurs.
Instructions:
1. After viewing the ATI video case study on Metered dose inhalers, complete the following questions
using the ATI pharm text, Frandsen & Pennington pharm text, or Davis Drug Guide.
2. Cite your information in your answers. Include a reference section in APA format. Answers should be
at least one to two paragraphs.
3. Post your completed project in the Forums section of the Reggienet course.
4. The assignment is worth 12 points. Due Friday April 9th at 11:55pm.
Metered-dose inhalers:
Scenario 0900
The client is a 50-year-old male admitted with asthma and COPD to the medical-surgical unit. The nurse is
preparing the 0900 medications. Beclomethasone and albuterol metered-dose inhalers are prescribed.
1. How will these medications help the client’s asthma/COPD? Which of the two inhalers should
be administered first? Support your answer.
Beclomethasone will decrease frequency and severity of asthma attacks by locally acting as
an anti-inflammatory and immune modifier. Which will improve asthma symptoms (Vallerand
& Sanoski, 2021). Albuterol will treat or prevent bronchospasms in asthma or chronic
obstructive pulmonary disease (COPD) serving as a bronchodilator. This will be accomplished
by binding to “beta2 -adrenergic receptors in airway smooth muscle, leading to activation of
adenyl cyclase and increased levels of cyclic-3', 5'-adenosine monophosphate (cAMP)”
(Vallerand & Sanoski, 2021). Which the increase in cAMP activate kinases then inhibits the
phosphorylation of myosin and decrease intracellular calcium. Decreasing intracellular calcium
which then relaxes smooth muscle airways. When it comes to deciding which inhaler should be
administer first, that would be Albuterol. The patient has to use Albuterol first if using other
inhalation medications and allow 5 min to elapse before administering other inhalant
medications unless otherwise directed (Vallerand & Sanoski, 2021). The reason being that
Albuterol prevents bronchospasms which open up the lungs better, making it easier for other
inhalers to be absorbed better and work better (Frandsen & Pennington, 2021, p.657).