Definition
Performing nebulization therapy is a key respiratory nursing intervention that delivers aerosolized medication directly into the lungs. It’s especially useful for patients with asthma, COPD, bronchitis, bronchiolitis, or thick respiratory secretions.
Purposes
- To administer medications directly into respiratory tract for sputum expectoration.
- To reduce difficulty in bringing out thick tenacious respiratory secretions.
- To increase vital capacity.
- To relieve dyspnoea
Articles
- Air compressor
- Connecting tube
- Nebulizer
- Medication” and saline solution
- Sterile water
- Cotton balls
- Face mask
- Sputum cup with disinfectant
- Disposable tissue
- Kidney tray
“Drugs commonly administered by nebulizer are l-agonist, anticholinergics, corticosteroids and antibiotics.
Procedure
| Nursing Action | Rationale |
| Before procedure 1. Identify patient and check physician’s instructions and nursing care plan. 2.Monitor heart rate before after the treatment for patient using bronchodilator drugs. 3. Explain the procedure to the patient. This therapy depends on patient’s effort. 4.Place the patient in a comfortable sitting or a semi- Fowler’s position. During procedure 5.Add the prescribed amount of medication and saline or sterile water to the nebulizer. Connect the tubing to the compressor. A fine mist from the device should be visible. 6.Place mask on patient’s face to cover his mouth and nose and instruct him to inhale deeply and slowly through mouth hold breath and then exhale several times. 7. Observe expansion of chest to ascertain that patient is taking deep breaths. 8.Instruct the patient to breathe slowly and deeply until all the medication is nebulized. 9.On completion of the treatment, encourage the patient to cough after several deep breaths. 10. Observe patient for any adverse reaction to the treatment. After procedure 11. Record medication used, and description of secretions expectorated. 12. Disassemble and clear nebulizer after each use. Keep the equipment in patient’s room. The tubing is changed every 24 hours. 13. Wash hands | Proper explanation of the procedure helps to ensure patient’s cooperation and effectiveness of the treatment. Diaphragmatic excursion and lung compliance are greater in this position. This ensures maximal distribution and deposition of aerosolized particles to base of lungs. Aerosol particles enable deep penetration into tracheobronchial tree. This encourages optimal dispersion of the medication This will ensure that medication is deposited below the level of oropharynx. Medication will usually be nebulized within 15 minutes, Medication will usually be nebulized within 15 minutes Patient may develop bronchospasms due to inhalation of aerosol. The fluid may also cause dried and retained secretion in airways, leading to narrowing of airway. Proper cleaning, sterilization, and storage of equipment prevents organisms from entering the lung |
Special Considerations
- If indicated, provide nebulization using oxygen source.
- The delivery time should not exceed 10-15 minutes with an optimum flow rate of 8 L/min.
- Diluents should be used only if prescribed by the physician in a1:4 ratio. The commonly used diluent is NaCl 0.9%.
- For patients receiving long-term nebulization therapy, the chamber should be replaced every three months.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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