Nebulization is the process of medication administration via inhalation. It utilizes a nebulizer which transports medications to the lungs by means of mist inhalation.
Indication
Nebulization therapy is used to deliver medications along the respiratory tract and is indicated to various respiratory problems and diseases such as:
Bronchospasms
Chest tightness
Excessive and thick mucus secretions
Respiratory congestions
Pneumonia
Atelectasis
Asthma
Contraindications
In some cases, nebulization is restricted or avoided due to possible untoward results or rather decreased effectiveness such as:
Patients with unstable and increased blood pressure
Individuals with cardiac irritability (may result to dysrhythmias)
Persons with increased pulses
Unconscious patients (inhalation may be done via mask but the therapeutic effect may be significantly low)
Equipments
Nebulizer and nebulizer connecting tubes
Compressor oxygen tank
Mouthpiece/mask
Respiratory medication to be administered
Normal saline solution
Procedure
Position the patient appropriately, allowing optimal ventilation.
Assess and record breath sounds, respiratory status, pulse rate and other significant respiratory functions.
Teach patient the proper way of inhalation:
Slow inhalation through the mouth via the mouthpiece
Short pause after the inspiration
Slow and complete exhalation
Some resting breaths before another deep inhalation
Prepare equipments at hand
Check doctor’s orders for the medication, prepare thereafter
Place the medication in the nebulizer while adding the amount of saline solution ordered.
Attach the nebulizer to the compressed gas source
Attach the connecting tubes and mouthpiece to the nebulizer
Turn the machine on (notice the mist produced by the nebulizer)
Offer the nebulizer to the patient, offer assistance until he is able to perform proper inhalation (if unable to hold the nebulizer [pediatric/geriatric/special cases], replace the mouthpiece with mask
Continue until medication is consumed
Reassess patient status from breath sounds, respiratory status, pulse rate and other significant respiratory functions needed. Compare and record significant changes and improvement. Refer if necessary
Attend to possible side effects and inhalation reactions
Complications
Possible effects and reactions after nebulisation therapy are as follows:
Palpitations
Tremors
Tachycardia
Headache
Nausea
Bronchospasms (too much ventilation may result or exacerbate bronchospasms)
Teachings
As nurses, it is important that we teach the patients the proper way of doing the therapy to facilitate effective results and prevent complications (demonstration is very useful). Emphasize compliance to therapy and to report untoward symptoms immediately for apposite intervention.