A nurse is educating a client on how to self-administer a metered dose inhaler (MDI). The client should be in a dropdown position and dropdown before use.

• Sitting: The sitting position promotes optimal lung expansion and helps the client achieve maximum inhalation of the medication. Proper posture ensures that the airways are open and reduces the risk of aspiration or ineffective drug delivery. Sitting upright also enhances coordination between actuation and inhalation. • Shake the inhaler: Shaking the metered dose inhaler mixes the medication and propellant evenly, ensuring a consistent and accurate dose is delivered. Failing to shake the inhaler can result in uneven dosing, reducing the effectiveness of therapy and potentially worsening the client’s respiratory symptoms.