STEAM INHALATION (Hot Application) – Purpose, Preliminary Assessment, Preparation of

Patient and Environment, Equipment, Procedure and After Care

Inhalation is defined as the drawing of air or other vapors 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 Celcius
 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
 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
Procedure
 Wash hands
 Open sterile inhaler mouth – piece and cover with sterile gauze and attach to clean inhaler
 Close spout of inhaler with cotton ball. Pour boiling water up to spout. Add medicine (tincture
benzoin) if needed. Close inhaler with mouth piece and take to bed side
 Face spout away from patient and remove cotton ball
 Instruct to take in deep breath through mouth and breathe out through nose
 Continue procedure for 15 to 20 minutes keep patient warm throughout to prevent chilling
 Give chest physiotherapy and encourage patient ot bring out sputum
After Care
 Remove the inhaler from the patient
 Use face towel to wipe of perspiration from his face
 Remove the accessories and make the patient comfortable
 Replace the articles after cleaning
 Wash hands
 Record the procedure in nurse’s record sheet

Nebulization

Definition
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
1. Position the patient appropriately, allowing optimal ventilation.
2. Assess and record breath sounds, respiratory status, pulse rate and other significant respiratory
functions.
3. 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
4. Prepare equipments at hand
5. Check doctor’s orders for the medication, prepare thereafter
6. Place the medication in the nebulizer while adding the amount of saline solution ordered.
7. Attach the nebulizer to the compressed gas source
8. Attach the connecting tubes and mouthpiece to the nebulizer
9. Turn the machine on (notice the mist produced by the nebulizer)
10. 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
11. Continue until medication is consumed
12. 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
13. 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.

References:
RNPedia. (n.d.). Nebulization Therapy. Retrieved from: https://www.rnpedia.com/nursing-notes/medical-
surgical-nursing-notes/nebulization-therapy/
Nurseinfo. (n.d.). Steam Inhalation (Hot Application). Retrieved from: https://nurseinfo.in/steam-
inhalation-hot-application/