A nurse is teaching a client who has asthma how to use a metered-dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. Arrange the following steps in the correct order:

Inhale deeply and then exhale completely.

Place her lips firmly around the mouthpiece.

Breathe in deeply over 2 to 3 seconds while pushing down on the canister.

Hold her breath for 10 seconds.

Exhale slowly through pursed lips.

Wait 60 seconds between each puff.