Certified Respiratory Therapist Practice Exam

For a 2-year-old child experiencing severe asthma, what is the preferred delivery system for a bronchodilator?

1. Metered Dose Inhaler without a spacer

2. Small-volume nebulizer

3. MDI with holding chamber and a mask

4. Open tube system

The correct answer is: MDI with holding chamber and a mask

The preferred delivery system for administering a bronchodilator to a 2-year-old child experiencing severe asthma is a metered dose inhaler (MDI) with a holding chamber and a mask. This combination is highly effective for young children because it allows for easier inhalation of the medication. The use of a holding chamber helps to ensure that the medication is delivered more effectively into the lungs and reduces the chance of deposition in the upper airway, which is particularly important in younger patients who may struggle with proper inhalation technique. A holding chamber provides a space for the aerosolized medication to mix with air, allowing the child to inhale a more concentrated dose of the medication even if they do not take deep, controlled breaths. Using a mask further facilitates delivery, as it can cover the child's nose and mouth without requiring them to perform specific inhalation techniques, making it especially suitable for toddlers who might be uncooperative or unable to follow instructions. This method ensures that the bronchodilator is administered safely and effectively to relieve bronchospasm and improve airflow during an asthma exacerbation. The preference for MDI with a holding chamber and mask over other delivery systems lies in its ability to optimize medication delivery, improve patient compliance, and minimize wasted medication, which is crucial