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: 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).