ILOILO DOCTORS’ COLLEGE

COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

ADMINISTERING INHALED MEDICATIONS

BY SMALL-VOLUME NEBULIZERS
Performance Checklist
Student’s Name: ______________________________Score/ Equivalent: ________________
Year & Section: ________________________________Date Performed: _________________

PERFORMANCE RATING
4 – Consistently demonstrates high level performance
3 – Satisfactorily achieves performance based on standard
2 – Performs task with difficulty
1 – Unable to perform tasks as required

PROCEDURE 4 3 2 1
1 Gathered equipment.
2 Checked each medication order against the physician’s order according to
agency policy
3 Identified the actions, special nursing considerations, safe dose ranges,
purpose of administration and adverse effects of the medication to be
administered.
4 Identified patient, introduced self and explained the procedure.
5 Assessed pulse, respiratory rate, breath sounds, oxygen saturation before
beginning the treatment.
6 Identified if the patient is allergic to the drug to be administered.
7 Assembled the nebulizer as per manufacturer’s instructions and according
to patient’s need.
8 Identified if the patient is unable to tolerate using a mouthpiece,
9 Prepared a mask is patient is unable to tolerate using a mouthpiece,
assembled the adaptor for tracheostomy.
10 Performed hand hygiene.
11 Removed the nebulizer cup from the device and opened it.
12 Added unit-dose medication in the bottom section of the cup. Added
prescribed diluents as required.
13 Covered the top portion of the nebulizer cup back into place and attached
the cup to the end of the tubing. The other end of the tubing is attached to
the nebulizer.
14 Positioned the patient sitting up in a chair or in bed at greater than 45
degrees.
15 Turned on air to nebulizer and ensured that a sufficient mist is visible exiting
nebulizer chamber.
16 Had the patient place the mouthpiece into mouth and instructed to grasp
securely with teeth and lips.
17 Instructed the patient take slow, deep, inspiratory breaths. Encouraged a
brief 2- to 3-second pause at the end of inspiration, and continue with
passive exhalations.
18 Had the patient repeat the breathing pattern until medication is complete
and there is no visible misting.
19 Tapped the nebulizer chamber occasionally and at the end of the treatment.
20 Turned the flowmeter off after treatment has been completed and
disconnected nebulizer.
21 Had the patient gargle with water after treatment.
22 Reassessed lung sounds, oxygen saturation, pulse and respirations.
23 Performed hand hygiene.
24 Documented patient’s response to therapy.
25 Cleansed and stored nebulizer as per agency policy.
TOTAL

Student’s Signature :__________________ Instructor’s Signature: __________________

Verified:

CYGNETTE S. LUMBO, R.N., Ph. D.

Clinical, Coordinator, IDC-College of Nursing

Approved:

MA. JOSEPHINE B. PROVIDO, R.N., PH. D.

Dean, IDC- College of Nursing
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

MONITORING OXYGEN SATURATION USING A PULSE OXIMETER

Performance Checklist

Student’s Name: ______________________________Score/ Equivalent: ________________

Year & Section: _______________________________Date Performed: _________________

PERFORMANCE RATING
4 – Consistently demonstrates high level performance
3 – Satisfactorily achieves performance based on standard
2 – Performs task with difficulty
1 – Unable to perform tasks as required

PROCEDURE 5 4 3 2 1
1 Identified the patient and introduced self.
2 Explained the purpose of the procedure.
3 Performed hand hygiene.
4 Selected an adequate site for the application of the sensor.
o Index, Middle or Ring Finger
o Toes
o Earlobe or Bridge of the Nose (to use a special type of
oximeter)
5 Checked proximal pulse and capillary refill at the pulse closest to the
site.
6 Chose oximeter probes appropriate for patient’s age and size.
7 Prepared the monitoring site by removing nail polish or artificial
nails.
8 Cleansed the selected area with alcohol wipes/ cotton with alcohol
and allowed to dry.
9 Turned on the oximeter and checked operation of the equipment if
properly working.
10 Applied probe securely to the skin, making sure that the light
emitting sensor and light- receiving sensor are aligned opposite
each other.
11 Checked oxygen saturation reading. Identified alarm limits for high
and low pulse settings.
12 Removed sensor and checked for signs of skin pressure or irritation.
13 Cleansed sensor according to manufacturer’s direction.
14 Performed hand hygiene.
15 Identified deviations and documented findings.
TOTAL

Student’s Signature :__________________ Instructor’s Signature: __________________

Verified:

CYGNETTE S. LUMBO, R.N., Ph. D.

Clinical, Coordinator, IDC-College of Nursing

Approved:

MA. JOSEPHINE B. PROVIDO, R.N., PH. D.

Dean, IDC- College of Nursing