A patient with chronic obstructive pulmonary disease (COPD) is to use a nebulizer. The observation that indicates the nebulizer is being used incorrectly and additional teaching by the nurse is required would be that the patient:
  1. Holds the inspired breath for at least 3 seconds
  2. Inhales with the lips tightly sealed around the mouthpiece of the nebulizer
  3. Places the tip of the nebulizer just beyond the lips
  4. Exhales slowly through the mouth with the lips pursed slightly
Explanation
Answer - B - The observation that indicates the nebulizer is being used incorrectly and additional teaching by the nurse is required would be that the patient inhales with the lips tightly sealed around the mouthpiece of the nebulizer. This technique results in nasal breathing, which negates the effects of aerosol medication.
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