DEFINITION:

Inhalation is defined as the drawing of air or other vapours into lungs through mouth or nose. Steam
inhalation is defined as utilization of moist heat to loosen lung congestion and help liquify secretions.

PURPOSE:
 To relieve inflammation of the mucus membrane in acute colds and in sinusitis.
 To relieve irritation in bronchitis and whooping cough by moistening.
 To provide antiseptic action on the respiratory tract.
 To provide warm and moist air following operation, e.g. tracheotomy.
 To soften thick, tenacious mucus and relieve coughing.

TYPES OF INHALATIONS:
 Dry-Inhalation: ether, chloroform, nitrous oxide, menthol, eucalyptus and spirit
ammonia.
 Water moist inhalation: plain steam, tincture benzoic, menthol in alcohol and oil of
eucalyptus solution.

INDICATION OF TINCTURE BENZOIN INHALATION:

 Purulent bronchitis.
 Bronchiectasis.
 Lung abscess.
 Common cold and sore throat.

GENERAL INSTRUCTIONS:
 The temperature of the water should be remaining between 120- and 160-degree F or
54.4 and 76.7 degree Celsius.
 Water in the inhaler should remain just below the spout to avoid scalding.
 The spout of the inhaler must be placed in such a way that the patient cannot touch it
or put his face too near.
 Keep the patient warm and prevent drought before, during and after the inhalation.
 When volatile groups like menthols are used to keep his eyes closed to prevent the
drug irritating the conjunctiva.
 Observe the patient closely throughout the procedure.

PRELIMINARY ASSESSMENT:
check-
 The doctors order for any specific instructions
 General condition and diagnosis of the patient
 Self-care ability to follow instructions
 Type, duration and medication of inhalation
 Articles available in the unit
PREPARATION OF THE PATIENT AND ENVIRONMENT:
 Explain the procedure to the patient.
 Allow the patient to empty to the bladder and towels if necessary. Given bedpan or
urinal to a bedridden patient.
 Provide Fowler’s position with back rest, cardiac table and extra pillows.
 Close windows, doors and put off fan to prevent drought.
 Provide sputum cup within the reach of the patient.
 Provide a face towel to remove sweat from face during inhalation.
 Mouth piece should be boiled and cooled before use.
 Arrange the articles at the bedside.

EQUIPMENT:
A tray containing:

 Nelson’s inhaler in a large bowel wrapped with towel.

 Face towel and patient towel – 1.
 Bath blanket.
 Tincture benzoin.
 Teaspoon, dropper.
 Kettle with boiling water.
 Gauze pieces.
 Cotton swabs.
 Swab sticks.
 Kidney tray and paper bag.
 Sputum cup.
PROCEDURE:

Sl. Nursing Action Rationale

no.
1. Check for the doctor’s order. To plan the care.
2. Explain the procedure to the patient. Enhances cooperation and allays fear.
3. Wash hands. To reduce the risk of infection.
4. Remove the lid of the kettle; check the Too low temperature may not serve the
temperature of the water using the lotion purpose.
thermometer.
5. Open sterile inhaler mouth – piece and cover To prevent heat loss.
with sterile gauze and attach to clean inhaler.
Close spout of inhaler with cotton ball. Pour
boiling water up to spout.
6. Add medicine (tincture benzoin) if needed. To prevent heat loss.
Close inhaler with mouth piece and take to
bed side.
7. Position the patient in Fowler’s position. To provide support.
Support with cardiac table or extra pillows
as needed.
8. Keep the sputum cup within reach the To expel the sputum as needed.
patient.
9. Face spout away from patient and remove To liquefy and loosen the secretions.
cotton ball. Instruct to take in deep breath To promote atmospheric air entry.
through mouth and breathe out through nose.
Continue procedure for 15 to 20 minutes
keep patient warm throughout to prevent
chilling.
10. Give chest physiotherapy and encourage To mobilize the secretions.
patient to bring out sputum.

11. Reposition the patient comfortably. To promote comfort.

12. Replace the articles. For the next use.
13. Wash hands. To prevent cross infection.
14. Document the procedure done. Legal evidence and to prevent duplication
of care.

EVALUATION:
 Evaluate the patient’s response.
 Auscultate the lungs to assess the lung sounds.
 Evaluate the sputum color, thickness and odor.
  Monitor the respiratory rate.

PULSE OXYMETRY

INTRODUCTION:
The tissues in our body require oxygen to function. Respiratory system also helps the body maintain
hemostasis or balance among the many elements of the body’s internal environment.
DEFINITION:
Pulse oximetry is the noninvasive measurement of arterial blood oxygen saturation-the percent to
which hemoglobin is filled with oxygen.
Pulse oximeter is a machine that detects the pulse from an arterial blood supply and the percentage
of oxygen saturation is calculated.
PURPOSES:
 To monitor the effectiveness of oxygen therapy.
 To monitor the oxygen saturation of arterial blood.
 Alerting to dangerously low oxygen levels, particularly in new born.
 Offering peace of mind to people with chronic respiratory or cardiovascular conditions.
 Assessing the need for supplemental oxygen.
 Monitoring oxygen saturation levels in people under anaesthesia.
 Indicating dangerous side effects in people taking drugs that affect breathing or oxygen
saturation.

INDICATION:
 Patients who are sedated or under the effects of anesthesia.
 Unstable patients who require transportation and continuous oxygen monitoring.
 Patients with respiratory illness such as COPD and asthma.
 Patients who are on respiratory depressants, for example, patient-controlled analgesia.
 Patients with unstable oxygen status or at risk for impaired gas exchange.

MECHANISM:
 The light-emitting diode emits light in wavelengths that are absorbed differently by the
oxygenated and deoxygenated hemoglobin molecules.
 The amount of light transmitted through the tissues is then converted to a digital value
representing the percentage of hemoglobin saturated with oxygen.
 The more hemoglobin saturated by oxygen, the higher is the oxygen saturation.
 Normally oxygen saturation (SpO2) is greater than 90%.

SITE LOCATION:
 Site must have adequate local circulation and be free from moisture.
 A nail free of polish is preferred to reduce the wrong readings.
  If the patient has tremors or is likely to move, use earlobe or forehead.
 If the patient is obese, clip or probe may not fit properly; hence, obtain a disposable probe.

PREPARATION OF EQUIPMENT:
 Pulse oximeter with probe or
 Probe with cardiac monitor.
 Spirit cotton balls.

Sl.no. Nursing Action Rationale

1. Arrange the equipment at the bedside. For easy use.

2. Explain the purpose of the procedure to Gains cooperation and confidence.

the patient.
3. Perform hand hygiene. Reduces transmission of microorganisms.
4. Position comfortably. Support the lower To enhance comfort.
arm.
5. Remove the nail polish if present. Contains blue pigment; absorbs light
transmission and alters the measurement of
saturation.
6. Attach sensor to monitoring site. To detect saturation.

7. Once sensor is in place, turn on the Enables detection of valid pulse.

oximeter by activating power. Observe
pulse waveform/intensity display and
audible deep. Correlate oximeter’s pulse
rate with the patient’s radial pulse.
8. Leave sensor in place until oximeter Reading takes 10-30 seconds depending on
display reaches constant value and pulse the site selected.
display reaches full strength during each
cardiac cycle.
9. Inform the patient that oximeter alarm Reduces anxiety.
will sound if sensor falls or if the patient
moves. Read SpO2.
10. If oxygen saturation is to be checked Avoids frightening the patient and for
continuously, verify SpO2 alarm limits communicating the signal to the nurse.
preset by the manufacturer at a lower
limit of 85% and a higher limit of 100%.
11. If it is an intermittent or spot checking, Safeguards the battery.
remove probe; turn oximeter power off.
12. Record the findings. For further comparison.
13. Position the patient comfortably. Enhances comfort.
 14. Perform hand hygiene. Reduces transmission of microorganisms.

EVALUATION:
 Compare SpO2 with the patient’s previous baseline and acceptable SpO2.
 During continuous monitoring, assess skin integrity underneath probe at least every 2 hours,
based on the patient’s peripheral circulation.

RECORDING AND REPORTING:

 Record the date, time, site of probe placement and the reading.
 Specify the type and amount of oxygen if the patient is on oxygen flow.
 Report any abnormalities.
 TIPS, NURSING SECTION.

PROCEDURE
ON
STEAM INHALATION

SUB: ADVANCED NURSING PRACTICE.

SUBMITED TO, SUBMITTED BY,

MRS, GARGI MAITY. PINKI DEB.
(ASSOCIATE PROFESSOR). ROLL NO- 04.
TIPS, NURSING SECTION. M.Sc. NURSING 1 ST SEM.
TIPS, NURSING SECTION.

DATE OF SUBMISSION: 23/12/2021.

 TIPS, NURSING SECTION.

PROCEDURE
ON
PULSE OXYMETRY

SUB: ADVANCED NURSING PRACTICE.

SUBMITED TO, SUBMITTED BY,

MRS, GARGI MAITY. PINKI DEB.
(ASSOCIATE PROFESSOR). ROLL NO- 04.
TIPS, NURSING SECTION. M.Sc. NURSING 1 ST SEM.
TIPS, NURSING SECTION.

DATE OF SUBMISSION: 23/ 12/2021.

 BIBLIOGRAPHY

 Kluwer Wolters, “Manual of nursing procedures and practice”, Wolters Kluwer (India) Pvt.
Ltd., New Delhi, Second Edition, Section:01, Page no:120-121.
 BIBLIOGRAPHY

 Kluwer Wolters, “Manual of nursing procedures and practice”, Wolters Kluwer (India) Pvt.
Ltd., New Delhi, Second Edition, Section:01, Page no: 83-85.