CHECKLIST FOR STEAM INHALATION

USING A NELSON’S INHALER

S.NO CONTENT DEMO RETURN PRACTICE PRACTICE

DEMO 1 2

1 PURPOSE –
 To relieve the inflammation and congestion of the
mucous membrane of the respiratory tract and
paranasal sinuses, thus to produce symptomatic
relief in acute cold and sinusitis.
 To soften thick tenacious mucous and help its
expulsion from the respiratory tract thus to relief
cough in bronchitis, and postoperative cases, etc.
 To provide heat and moisture and to prevent the
dryness of mucous membranes of lungs and upper
respiratory passages following operations such as
tracheostomy.
 To aid in the absorption of oxygen.
 To relieve spastic condition of the larynx and
bronchi.
 To provide antiseptic action on the respiratory tract,
e.g. by using menthol, tincture benzoin, eucalyptus,
etc..
DRUGS USED
 Tr. Benzoin 5ml per 500ml of boiling water.
 Eucalyptus 2ml per 500ml boiling water.
 Methyl salicylate few drops per 500ml boiling
water.
 Menthol few crystals per 500ml boiling water.
 Camphor few crystals per 500ml boiling water.

PRELIMINARY ASSESSMENT
 Check the patient’s name, bed number and other
identification
 Check the diagnosis and the general condition of
the patient.
 Check the physician’s orders to see the specific
precaution for the patient’s movement and
positioning.
 Assess the patient’s ability for self care, his ability
to move and to maintain the desired position.
  Assess the level of consciousness and the ability to
follow instructions.
 Check the articles available in the patient’s unit..

2 ARTICLES REQUIRED-
 Nelson’s inhaler with a mouth piece tightly fit to
the neck of the inhaler.
 Bowel or basin large enough to hold the inhaler.
 A flannel piece or a towel.
 Face towel
 Bath blanket or bath towel
 Tr. benzoin or any other inhalant ordered
 Teaspoon or a minim glass.
 Kettle with boiling water.
 Gauze piece in a container.
 Cotton swabs in a container.
 Kidney tray and paper bag.
3 PREPARATION OF THE PATIENT-
 Explain procedure to the patient.
 Make the patient to understand that he has to
remain in the bed one to two hrs more after
inhalation.
 Ask patient to for to toilet and empty the bladder
and bowel if necessary.
 Place the patient in a fowler’s position with a
cardiac table in front.
 Close the doors and windows and put off the fan to
prevent the draught.
 Place the sputum cup in a convenient place within
the easy reach of patient.
 Provide a face towel to the patient to wipe the
sweating from face during inhalation.

4 PROCEDURE:
 Warm the inhaler by pouring a little hot water into
the inhaler and emptying it after one minute.
 Pour the required amount of inhalant into the
inhaler and fill to a level below the spout with
boiling water. The water should remain just below
the spout.
 Place sterile mouthpiece and close the inhaler
tightly. See that the mouthpiece is in the opposite
direction to the spout.
 Cover the mouth piece with a gauze piece and plug
the spout with a cotton ball.
 Place a towel around the inhaler and position it in
the bowl.
 Take it to the patient without losing time.
 Place the apparatus conveniently in front of the
patient on cardiac table with spout opposite to the
patient. Remove the cotton plug and discard it into
the kidney tray.
 Instruct the child to place lips on the mouthpiece
and take deep breath. After removing the lips from
the mouthpiece, breathe out air through nose.
 Continue the treatment for 15 to 20 minutes as long
as patient gets the vapours. Observe the child
during procedure.
 Remove inhaler from the patient after the stated
time, wipe off perspiration from the patient’s face.
 Give chest physiotherapy and encourage patient to
bring out sputum by coughing.
 Instruct the patient to remain in the bed for 1 to 2
hours.
5 AFTER CARE:
 Take articles to the utility room, empty the inhaler,
clean the inside with alcohol to remove Tr.benzoin.
Wash it with warm soapy water and then rinse with
clean water.
 clean the ounce glass with alcohol swab followed
by soapy water.
 Remove the gauze covering the mouthpiece and
wash the mouthpiece with soap and water and send
for autoclaving.
 Dry the articles and replace them. Wash hands.
6 RECORDING AND REPORTING:
 Record the procedure in nurse’s record with date,
time, Purpose and patient’s response to the
procedure.
 CHECKLIST FOR NEBULIZATION
S.NO CONTENT DEMO RETURN PRACTICE PRACTICE
DEMO 1 2

1 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 dyspnea.

3 ARTICLES REQUIRED-
 Air compressor
 Connecting tube
 Nebulizer
 Medication and saline solution
 Sterile water
 Cotton balls
 Face mask
 Sputum cup with disinfectant
 Disposable tissues
 Kidney tray
4 PROCEDURE:
Preprocedural steps-
 Identify patient and check physician’s order and
nursing care plan
 Assemble the articles and bring them near bedside
 Explain the procedure to the child and/or to the
family.
 Place the child in a comfortable, upright position.
 Wash hands
 Clean the mask with normal saline swabs and dry it
and clean the tubings with spirit swabs.
 Add the prescribed amount of medication and saline
or sterile water to the nebulizer.
 Clean the nostrils if dirty
 Connect the tubing to the compressor and turn on
the pump. A fine mist from the device should be
visible.
Intraprocedural steps
 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.
 Observe expansion of chest to ascertain that patient
is taking deep breaths.
 Instruct the child to breath slowly and deeply until
all the medication is nebulized.
 Monitor child’s oxygen saturation level throughout
the procedure
Post procedural steps
 On completion of the treatment encourage the
patient to cough after several deep breath.
 Observe patient for any adverse reaction to the
treatment.
 Record medication used and description of
secretion expectorated.
 Disassemble and clear nebulizer after each use.
Keep the equipment in patient’s room. The tubing
is changed every 24 hours.
 Wash hands.
5 SPECIAL CONSIDERATION-
If indicated provide nebulization using oxygen
source.