NORCET 6 Prelims -2024: Mother of a 3 year-old child ask the nurse about instruction the use of spacer .what will you tell the mother…

NORCET 6 Prelims -2024

Pediatric Nursing

Hard

Appeared in: NORCET 6 Prelims -2024

Explanation

The correct instruction is to wait between puffs to ensure the medication is delivered effectively.
According to nursing fundamentals textbooks, a pause of 20 to 30 seconds is recommended between puffs of the same medication.
This waiting period allows the metered-dose inhaler (MDI) canister to repressurize, ensuring the second puff contains the full, intended dose.
Failing to wait can result in a significantly reduced amount of medication being delivered in the second puff, compromising treatment efficacy.

Option A: Rinsing the mouth 30 minutes after using a steroid inhaler is too late to be effective in preventing oral candidiasis (thrush).
Option B: While breathing for 30 seconds might deliver the medication, the standard and more precise instruction for a young child is to take 5-10 normal (tidal) breaths per puff.
Option C: A 3-year-old child lacks the cognitive ability and coordination to perform a deep inhalation followed by a breath-hold.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pediatric Medication Administration: Inhaler and Spacer Technique to guide bedside assessment, documentation, and the next nursing action.
Correct inhaler and spacer technique is critical for effective asthma and respiratory disease management in children. Improper technique is a leading cause of treatment failure.
Patient and family education is a core nursing responsibility. Providing clear, simple, and accurate instructions ensures adherence and optimal clinical outcomes.
Nurses must demonstrate the technique and use teach-back methods to confirm the parent's understanding and ability to perform the procedure correctly.

How to Approach the Question

First, identify the key elements of the question: the patient's age (3 years old), the equipment (spacer), and the task (providing instructions).
Recall that a 3-year-old's ability to cooperate and follow instructions is limited. This immediately suggests that complex breathing maneuvers are incorrect.
Evaluate each option based on standard pediatric guidelines for inhaler use.
Option A (mouth rinse): Consider the purpose (preventing thrush) and timing. 30 minutes is too long.
Option C (deep breathing): Rule this out, as it's not feasible for a toddler. The correct technique is tidal (normal) breathing.
Option B (breathing for 30 sec): Compare this to the standard of 5-10 breaths. While one source mentions 30 seconds, it's less precise than counting breaths.

Concept Tested & Keywords

Concept Tested: Pediatric Medication Administration: Inhaler and Spacer Technique
Stem keywords: 3 year-old child, mother, instruction, spacer
Lead-in keywords: what will you tell
Clinical cues: Patient age (3 years old) is a key factor, as it dictates the use of a spacer with a mask and a tidal breathing technique.
Negative lead-in flag: false

Q6T81YCQkX7lHNNht0kYED

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 193-195

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1419-1421

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 35-37