“NEBULIZATION”

A. WHAT IS NEBULIZATION?
· Is a process of adding medications or moisture to inspired air
by mixing particles of various size with air.
· Adding moisture to the respiratory system through
nebulization may improve clearance of pulmonary secretions.

B. SPECIAL CONSIDERATIONS
·Should not be delegated to assistive personnel. Assistive
personnel should be instructed about potential side effects of
medications and to report their occurrences.
· Involves various factors such as patient-specific needs,
appropriate medication selection, dosage adjustment, and
ensuring proper equipment maintenance to prevent infection
transmission. Additionally, healthcare providers should consider
environmental factors like air quality and ventilation when
administering nebulized treatments.

C. EQUIPMENT
· Oximeter and stethoscope
· Gloves
· Medication ordered
· Nebulizer bottle and tubing assembly

D. NURSING RESPONSIBILITY
· Assessing the patient's respiratory status and need for
nebulization therapy.
· Ensuring proper medication administration by preparing the
correct dosage and medication according to the physician's order.
· Educating the patient and/or caregiver on the purpose of
nebulization, correct technique, and potential side effects.
· Monitoring the patient's response to the treatment, including
respiratory status, heart rate, and oxygen saturation levels.
· Documenting the administration of nebulization therapy,
including the medication administered, dosage, patient response,
and any adverse reactions.
· Maintaining and cleaning nebulization equipment according
to manufacturer's guidelines to prevent contamination and
infection transmission.
· Collaborating with other healthcare team members, such as
respiratory therapists and physicians, to ensure coordinated care
and optimal patient outcomes.

PROCEDURE:

ASSESMENT
1. Assess client’s vital signs, respiratory status, heart rate, before
the treatment. Check the doctor’s order.
PLANNING
2. Wash hands and assemble all the equipment and supplies
IMPLEMENTATION
3. Identify the client and verify the clients’ identity. introduce
yourself and explain the procedure and why it is necessary.
4. Provide for client privacy
5. Wear gloves
6, Place the client in semi-fowler’s position and drape accordingly.
7. Add the prescribed amount of medication or saline to the
nebulizer.
8. instruct the client to inhale, take a deep breath from the
mouthpiece and hold his breath briefly and exhale.
9. instruct the client to breath slowly and deeply.
10. Encourage coughing exercise after the treatment. Provide
bronchial tapping if permitted.
11. Disassemble and clean nebulizer after use.
12.Provide oral hygiene.
13. Wash hands.
EVALUATION
14. Evaluate effectiveness, description of secretion of any
secretion expectorated.
15. Assess the client’s vital signs, respiratory rate and heart rate
after the treatment.
G. Documentation
16. Record the medication used and the description of secretion
17. Record client’s vital signs, respiratory rate and heart rate after
the treatment.
Normal Values
1. Nebulization Rate: Typically ranges from 6 to 10 liters per
minute.
2. Particle Size: Ideally, particle size should be between 1 to 5
microns for effective deposition in the respiratory tract.
3. Duration: The duration of nebulization varies depending on the
medication and the patient's condition. It can range from a few
minutes to 15-20 minutes.

Analysis
1. Effectiveness: Assess how well the medication is being
delivered to the respiratory tract. This can be done by monitoring
the patient's symptoms, oxygen saturation levels, and pulmonary
function tests if available.
2. Tolerance: Observe the patient for any adverse reactions or
intolerance to the medication being nebulized.
3. Equipment Function: Regularly check the nebulizer equipment
for proper functioning, including the compressor, tubing, and
mask or mouthpiece.
4. Patient Compliance: Ensure the patient understands the
nebulization procedure and is compliant with the prescribed
regimen.
5. Clinical Response: Monitor the patient's clinical response to
nebulization therapy, including improvements in symptoms and
overall respiratory status.