Inhaler use by a client with asthma who continues to smoke, what is the best initial action by the nurse?

Inhaler use by a client with asthma who continues to smoke, what is the best initial action by the nurse?

• A. Revise the plan of care based on the client's plans to continue smoking.
• B. Review factors surrounding client's beliefs about smoking cessation.
• C. Inform the health care provider of this statement.
• D. Explain that denial of illness can interfere with the treatment regimen.

Answer: (A)

The key idea is patient-centered planning: care plans should reflect what the client is willing and ready to do. When a client with asthma who continues to smoke says they plan to keep smoking, the best initial action is to revise the plan of care to align with that goal. This acknowledges the client’s autonomy and creates a realistic foundation for the nurse to build on, ensuring all subsequent interventions are feasible and acceptable. It also sets up a structured opportunity to address smoking cessation in a respectful, stepwise way—educating and supporting the patient as they progress toward readiness, while continuing to manage asthma effectively, including correct inhaler use and trigger control. Exploring beliefs about cessation or notifying the provider are important, but aligning the plan with the patient’s stated plan is the most appropriate first move to ensure coherent, collaborative care.

The key idea is patient-centered planning: care plans should reflect what the client is willing and ready to do. When a client with asthma who continues to smoke says they plan to keep smoking, the best initial action is to revise the plan of care to align with that goal. This acknowledges the client’s autonomy and creates a realistic foundation for the nurse to build on, ensuring all subsequent interventions are feasible and acceptable. It also sets up a structured opportunity to address smoking cessation in a respectful, stepwise way—educating and supporting the patient as they progress toward readiness, while continuing to manage asthma effectively, including correct inhaler use and trigger control. Exploring beliefs about cessation or notifying the provider are important, but aligning the plan with the patient’s stated plan is the most appropriate first move to ensure coherent, collaborative care.