Nebulization Flashcards
What is the process of nebulization?
the process of dispersing a liquid (medication) into microscopic particles and delivered into the lungs as the patient inhales through a nebulizer.
Route of medication for nebulization
Medication administration via inhalation
Explain nebulization therapy
to liquefy and remove retained secretions from the respiratory tract.
Indications of Nebulization Therapy: Give 8 examples
- To relieve respiratory insufficiency due to bronchospasm
- To liquefy and remove retained thick secretions from the lower respiratory tract
- Chest tightness
- Respiratory congestions
- Pneumonia
- Atelectasis
- Asthma
- To reduce inflammatory and allergic responses in the upper respiratory tract
Contraindications of this procedure
- Unstable and increased blood pressure
- Individuals with cardiac irritability (may result in dysrhythmias)
- Increased pulses
- Unconscious patients (inhalation may be done via mask but the therapeutic effect may be significantly low)
5 Assessments before the procedure:
- patient’s respiratory status
- history of the episode of respiratory distress
- patient’s ability to use the nebulizer
- medications the client is currently taking
- patient’s knowledge regarding the use of a nebulizer
What Is a Nebulizer?
A device that uses a small compressor to convert a liquid into a mist so it can be inhaled directly into the lungs
A device that uses a small compressor to convert a liquid into a mist so it can be inhaled directly into the lungs
Nebulizer
Types of Nebulizer
- Pneumatic Jet
- Ultrasonic
- Mesh
What is Pneumatic Jet
uses compressed gas to make an aerosol (tiny particles of medication in the air)
uses compressed gas to make an aerosol (tiny particles of medication in the air)
Pneumatic Jet
Ultrasonic Nebulizers
makes an aerosol through high-frequency vibrations; the particles are larger than with a jet nebulizer
makes an aerosol through high-frequency vibrations; the particles are larger than with a jet nebulizer
Ultrasonic Nebulizers
Mesh Nebulizers
liquid passes through a fine mesh to form the aerosol. This kind of nebulizer puts out the smallest particles. (most expensive)
liquid passes through a fine mesh to form the aerosol. This kind of nebulizer puts out the smallest particles. (most expensive)
Mesh
Most expensive nebulizer
Mesh
Equipments for nebulization
- Nebulizer
- Nebulization kit: mouthpiece /mask
- Medication to be administered
- Normal saline solution
- Kidney basin
- Tissue
What is the first procedure?
- Verify the physician’s order and gather all the equipment needed
TRUE OR FALSE: No need to check identification and explain the procedure to the patient
FALSE: Check the identification of the patient and explain the procedure.
Why do we check the identity of the patient?
To make sure that the correct procedure will be performed to
the correct patient. Explaining the procedure helps ensure the patient’s cooperation and the effectiveness of the treatment.
What position and what to assess?
- Place the patient in a sitting or high fowler’s position. Assess and record breath sounds, respiratory status, pulse rate, and other significant respiratory functions.
Why do we need to place the p.t to a high fowler’s position?
Diaphragmatic excursion and lung compliance are greater in this position. This ensures maximal distribution and deposition of aerosolized particles to the base of the lungs.
TRUE OR FALSE: Nurse must provide instructions
TRUE: Provide instructions to the
patient
What instructions should we give to our patients in preparation for nebulization?
-to take slow, deep breaths
through the mouth
-pause after inspiration
-slow and complete exhalation
-some resting breaths before
another deep inhalation
Why do patients have to follow the instructions for nebulization?
To enable deep penetration
into the tracheobronchial tree
TRUE OR FALSE: after washing hands and opening the nebulization kit, we must attach the tubing to the port
TRUE: Wash hands.
Prepare the nebulizer and
open the nebulization kit.
Attach the tubing to the
machine port.
Why should we wash hands?
To prevent transmission of
microorganisms causing
infection
What are the ten rights to medication administration?
Right Drug, Right Patient, Right Dose, Right Route, Right Time and Frequency, Right Documentation, Right History, and Assessment, Drug approach and Right to Refuse, Right Drug-Drug Interaction and Evaluation, Right Education and Information.
TRUE OR FALSE: There is no need to know the 10 rights of med ad
Observe the 10 rights of medication administration
Do we add saline solution with medication into the cup?
YES: Place the medication into the medicine cup of the kit while adding the amount of saline solution ordered. Cover the cup and fasten it.
How to attach the mouthpiece? (8th)
Fasten the T-piece to the top of the cup then fasten the mouthpiece to the other end of the T-piece. Offer the mouthpiece and the patient’s lips must be sealed tightly around the mouthpiece.
How to attach the mask? (9th step)
Fasten the mask to the medicine cup. Place
the mask on the patient’s face to cover his/her mouth and nose.
When do we know if the medication has been completely delivered?
- Turn the machine on until the medication has been completely delivered (notice the mist produced by the nebulizer).
What should we observe as we offer the nebulizing kit to the patient and turn on the nebulizer
Observe the expansion of the chest to ascertain that the patient is taking deep breaths. This will ensure that the medication is deposited below the level of the oropharynx.
Ahat should we do once the patient completed their nebulization therapy?
On completion of the treatment, encourage the patient to cough after several
deep breaths. Perform back tapping. The medication may dilate airways facilitating the expectoration of secretions.
How do we do back tapping
By cupping our hands
TRUE OR FALSE: No need to observe the patient for adverse reaction
Observe the patient for any adverse reaction to the treatment.
What do we asses before and after nebulization?
assess the patient’s status: breath sounds, respiratory status, pulse rate, and other significant respiratory functions needed.
What do we do with our first and last assessment during nebulization therapy
Compare and record significant changes and improvements. Refer if necessary. Patients may develop bronchospasms due to inhalation of aerosol. The fluid may also cause dried and retained secretions in airways, leading to the narrowing of the airway.
TRUE OR FALSE: we can just dispose the nebulizer after usage
FALSE: Disassemble and clean the nebulizer after each use.
When do we change the tubing?
Tubings need to be changed every 48 hrs. Proper cleaning, sterilization,
and storage of equipment prevent organisms from entering the lungs.
What is the last step?
- Wash hands. Document the medication
used and the description of the secretions
Expectorated. Proper documentation is
proof of work done and observed
What do we document for this procedure
Document the medication
used and the description of the secretions
Expectorated.
