A 32-year-old man with asthma attends an outpatient follow-up two weeks after starting a prescribed daily inhaled corticosteroid/long-acting beta-agonist maintenance inhaler. His separate albuterol rescue inhaler is prescribed as needed for symptoms. He reports using albuterol almost every day for wheezing and sometimes forgetting the instructed mouth rinse after the maintenance inhaler. He is currently comfortable, alert and speaking in full sentences: BP 122/78 mmHg, HR 88/min, RR 20/min, SpO2 96% on room air and temperature 37.1°C. The prescriber previously taught his inhaler routine, and the LPN/VN is assigned to reinforce it. There is no order or protocol authorizing the LPN/VN to change the doses. What is the best initial response?
- Document the frequent albuterol use without notifying the RN or prescriber today.
- Increase the maintenance inhaler dose independently before the prescriber evaluates him.
- Remind him to use the maintenance inhaler as prescribed and rinse his mouth, then finish by asking whether he understands.
- Report the frequent albuterol use to the RN or prescriber and reinforce the prescribed technique and mouth rinse using return demonstration.