A nurse practitioner is caring for a 90-year-old adult with asthma who has comorbid dementia and severe osteoarthritis in the hands. The nurse practitioner considers inhaled medications to manage the asthma. Which of the following factors should the nurse take into consideration when developing the medication plan for this patient? (Select all that apply.)

A. The patient’s cognitive status: Cognitive impairment affects the ability to understand, remember, and properly use inhalers. The nurse must assess the patient’s mental capacity to follow inhalation techniques and may need to simplify the regimen or involve caregivers. B. The patient’s mobility status: While mobility limitations can impact access to medication or healthcare, they do not directly affect the patient’s ability to use an inhaler. Asthma management depends more on coordination and understanding than physical mobility. C. The patient’s age: Age alone does not determine medication effectiveness or inhaler choice. The nurse should focus on functional ability, cognitive status, and physical dexterity rather than chronological age when selecting appropriate inhalation therapy. D. The patient’s manual dexterity: Severe osteoarthritis in the hands can make pressing or holding an inhaler difficult. The nurse may consider spacer devices, nebulizers, or breath-activated inhalers to accommodate limited hand strength and flexibility. E. The patient’s ability to swallow safely: Some inhaled medications may be available in oral or capsule forms, requiring safe swallowing ability. Evaluating this factor prevents aspiration and ensures that medication delivery is both safe and effective for the patient’s condition.