A clinician is teaching inhaled corticosteroid technique. Which of the following should be included in teaching?

When teaching inhaled corticosteroid technique, the clinician should include the following steps:

1. Shake the Inhaler: Before using the inhaler, it should be shaken well for about 5 seconds. This helps to mix the medication inside it properly.

2. Exhale Fully: The patient should exhale fully to empty their lungs of as much air as possible.

3. Position the Inhaler: The inhaler should be positioned correctly. The bottom should be held with the index finger and thumb, and the mouthpiece should be directed towards the patient's mouth.

4. Inhale the Medication: The patient should close their lips around the mouthpiece and start to inhale slowly. As they begin to inhale, they should press down on the inhaler to release the medication. The patient should continue to inhale as slowly and deeply as they can.

5. Hold Breath: After inhaling the medication, the patient should try to hold their breath for about 10 seconds. This allows the medication to settle in the lungs.

6. Exhale Slowly: After holding their breath, the patient should exhale slowly.

7. Rinse Mouth: After using the inhaler, the patient should rinse their mouth with water and spit it out. This helps to prevent any medication from remaining in the mouth and throat, which can lead to side effects.

8. Clean the Inhaler: The inhaler should be cleaned regularly to prevent buildup of medication.

9. Repeat if Necessary: If more than one dose is prescribed, the patient should wait about 1 minute between inhalations.

10. Keep Track of Doses: Most inhalers have a dose counter to help keep track of how many doses are left. When the counter is close to 0, it's time to get a new inhaler.

Remember, it's important to demonstrate these steps to the patient and have them repeat back to ensure they understand the process.