Which caregiver statement indicates additional education is needed on giving albuterol by metered-dose inhaler?

• A. I should administer two quick puffs of the albuterol inhaler using a spacer.
• B. I should always use a spacer when administering the inhaler.
• C. My child should be in an upright position when using the inhaler.
• D. I should always shake the inhaler before giving a dose.

Answer: (A)

The main idea is that using a metered-dose inhaler with a spacer requires giving each puff separately with a short pause between puffs so the child can inhale the medication effectively. The spacer helps deliver the full dose even if coordination is imperfect, which is especially helpful for children.

Saying you should administer two quick puffs implies the second puff is given immediately after the first without a pause, which is not the best practice. A brief interval (about 30 seconds to 1 minute) between puffs allows the first dose to be inhaled and maximizes the second dose’s delivery.

Using a spacer is correct, as it improves deposition and reduces the need for perfect timing. An upright position and shaking the inhaler before use are also appropriate steps.