NEBULAZER

PERSIAPAN ALAT
HANDHELD NEBULIZER
1. Medication administration record (MAR)
2. Nebulizer set (cup, tubing, cap, T-shaped tube, mouthpiece, or mask) or
prepackaged nebulizer and applicator
3. Medication(s)
4. Saline
5. Air compressor, wall air, or wall oxygen

PENATALAKSANAAN
1. Assess client’s ability to use the nebulizer.
R : Ensures client compliance.
2. Check the MAR against the prescribing practitioner orders.
R : Ensures accuracy in the administration of medication. (Right drug)
3. Check for drug allergies and hypersensitivity.
R : Decreases the risk of allergic reaction such as hives, urticaria, or anaphylactic
shock.
4. Wash hands/hand hygiene before setting up the nebulizer; gather equipment
R : Reduces transmission of microorganisms.
5. Set up the medication(s) for one client at a time.
R : Ensures that client receives the right medication(s). (Right drug)
6. Look at the medication at eye level if using droppers to dispense the solution into
the nebulizer.
R : Increases accuracy. (Right dose)
A. Handheld Nebulizer and Gloves; B. Nebulizer Cup, Tubing, Cap, T-Shaped Tube,
Medication, and Mouthpiece

7. Pour the entire amount of the drug(s) into the nebulizer cup carefully.
• Avoid touching the drug while pouring into the nebulizer cup.
Determines the correct amount of medicine and ensures accurate dosage. (Right
dose)
• Reduces transmission of microorganisms.
8. Cover the cup with the cap and fasten.
R. Prevents spillage of the medication.
9. Fasten the T-piece to the top of the cap.
R. Provides a connector for the mouthpiece.
10. Fasten a short length of tubing to one end of the T-piece.
R. Provides dead space to prevent room air from entering the system and
medicated aerosol from escaping.
11. Fasten the mouthpiece or mask to the other end of the T-piece. • Avoid touching
the nebulizer mouthpiece or the interior part of the mask.
R. Provides a portal for the client to inhale the aerosolized medication. • Reduces
transmission of microorganisms.
12. Identify the client prior to administration of medication(s).
R. Ensures the right client gets the medication. (Right client)
13. Identify the medication(s) to the client, and clearly explain the therapeutic
purpose(s) of the medication
R. Promotes client’s cooperation and awareness of the medication’s effects.
14. Advise the client to sit in an upright position.
R. Promotes better expansion of the lungs.
15. Attach tubing to the bottom of the nebulizer cup, and attach the other end to the
air compressor or wall air. • Before turning it on, adjust the wall oxygen valve to 6
L/min (or less per prescribing practitioner’s orders). • Leave the air on for about 6
to 7 minutes until the medications get used up.
R. Provides a conduit for the compressed air. • Drives the medication into a mist
or wet aerosol form. • Allows the client to receive the entire dose of medication.
16. Instruct the client to breathe in and out slowly and deeply through the
mouthpiece or mask. • The client’s lips should be sealed tightly around the
mouthpiece. 16. Promotes better deposition and efficacy of the medication in the
airways.
17. Remain with the client long enough to observe the proper inhalation-exhalation
technique.
R. Ensures the correct use of the nebulizer to get the full effects from the
medications administered.
18. Wash hands/hand hygiene.
R. Reduces transmission of microorganisms.
19. Record the medications administered along with the date, time, and dosages on
the chart.
R. Provides documentation of administration of drugs.
20. When the nebulizer cup is empty, turn off the compressor or wall air. • Detach the
tubing from the compressor and the nebulizer cup. • If the nebulizer is
disposable, dispose of the nebulizer in the appropriate container. • If the
nebulizer is to be reused for this client, carefully wash, rinse, and dry the
nebulizer components.
 R. Stops the aerosolization. • Prepares components for cleaning or disposal. •
Prevents transmission of microorganisms. • Prevents transmission
21. Assess the client immediately following the treatment for results or adverse
effects from the treatment.
R. Allows the nurse to determine the effectiveness of the treatment.
22. Reassess the client 5 to 10 minutes following the treatment.
R.Some effects may be delayed.
23. Wash hands/hand hygiene.
R. Reduces transmission of microorganisms.

EVALUASI
• Evaluate the client’s need for medication delivery. Some clients, such as young
clients (usually less than 5 years old), clients with coordination problems, and
clients with severe or acute asthma, will benefit more from using a nebulizer. Some
clients, such as school-aged children, active adults, and clients with exercise-
induced asthma, will benefit more from the ease and portability of a metered-dose
inhaler.
• Be aware of the client’s ability to use the nebulizer device. Young children and
clients with acute or severe exacerbation may not be able to use the mouthpiece for
the nebulizer. A mask may provide better delivery of the medication(s).
• Measure the medication accurately by looking at the medicine dropper at eye level,
and pour the exact amount of medication needed into the cup.
• Familiarize yourself with all the asthma medications in order to be aware of any
outcomes the client may have from treatment. Some medications that the client
might be taking can interact with each other. Beta blockers (propranolol, atenolol,
and labetalol) can antagonize the beta agonists, increasing asthma symptoms. The
nurse needs to be familiar with the medications in order to anticipate possible
reactions.