A nurse is reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?

A. Cover exhalation slots of the spacer with lips when inhaling: You should seal your lips around the mouthpiece but do not cover any exhalation/ventilation ports; those must remain open. B. The spacer increases the amount of medication delivered to the oropharynx: A spacer decreases oropharyngeal deposition and increases delivery to the lungs. C. The spacer decreases the amount of medication delivered to the lungs: The spacer actually increases lung delivery by slowing particle velocity and allowing coordination-independent inhalation. D. Inhale slowly when using the spacer with the MDI: A slow, deep inhalation after actuating the MDI (or actuating into the spacer then inhaling) optimizes medication deposition in the lower airways.