NCM 109 RLE – CARE OF MOTHER, CHILD, AT RISK OR WITH PROBLEMS (ACUTE AND CHRONIC)

NEBULIZATION

DEFINITION: A method of administering a drug by spraying it into the respiratory passages of

the patient. The medication may be given with or without oxygen to help carry it into the lungs.

PURPOSES:
• To open the collapse alveoli and deliver medicated aerosol therapy.
• To relieve patient from having shortness of breath.
• Help expand the lungs thus loosen secretions.
• Commonly used at home on a long-term basis especially for those patients with Chronic
Obstructive Pulmonary Disease (COPD) to dispense inhaled medication.

INDICATIONS:
• Indicated to patient having difficulty in raising/expectorating respiratory secretions.
• Reduce vital capacity and less costly method of loosening secretions.

EQUIPMENT:
• Nebulizer machine
• Nebulizer kit/set (tubing, mouthpiece, manifold, mask)
• Syringe 3cc
• Saline solution (NSS)
• Air compressor, wall air, wall oxygen (O2 driven)
• Medication administration record
• Baffle (controls the air, helps in the convention)
• T-piece
 PROCEDURE RATIONALE
A. PREPARATION OF MEDICATION
1. Place the air compressor on a sturdy surface.
Plug the cord from the compressor into a
properly grounded (three prong) electrical outlet.
2. Wash your hands with soap and warm water, To prevent the spread of infection
and dry completely with a clean towel.
3. Carefully measure the medicine exactly as you To ensure that you give the correct amount of
have been instructed. Use a separate, clean medication
measuring device (eyedropper or syringe) for
each medicine. Look the medication at eye level.
4. Remove the top part of the nebulizer cup.
Place your medicine in the bottom of the
nebulizer cup.
5. Cover the cup and fasten. Connect and fasten
the mouthpiece/T-piece or face mask to the cup.
Then connect the tubing to both the aerosol
compressor and nebulizer cup.
B. PREPARATION OF THE PATIENT
6. Monitor patient’s heart rate before and after Bronchodilators may cause tachycardia,
treatment. palpitations, dizziness, nausea, or nervousness

7. Explain the procedure to the patient. This Proper explanation of the procedure helps to
therapy depends on patient’s effort. ensure the patient’s cooperation and
effectiveness of the treatment.
8. Place the patient in a comfortable sitting or Upright position can help expand the chest.
semi-fowler’s position. Diaphragmatic excursion and lung compliance are
greater in this position. This ensures maximal
distribution and deposition of aerosolized
particles to the base of lungs.
C. WORKING PHASE
9. Turn on the compressor with the on/off switch. Aerosol particles enable deep penetration into
Once you turn on the compressor, you should see tracheobronchial tree.
a light mist coming from the back of the tube
opposite the mouthpiece.
10. If using a mask, position it comfortably and This encourages optimal dispersion of the
securely on patient’s face. If using a mouthpiece, medication.
instruct patient to place it between teeth and
seal lips around. Nose clips are sometimes used if
the patient has difficulty breathing through the
mouth.
11.Instruct patient to take slow, deep breaths This will ensure that the medication is deposited
through your mouth. If possible, let him/her hold below the level in the oropharynx.
each breath for two to three seconds before
breathing out until all the medication is
nebulized.
12. Simultaneously do chest physiotherapy.
 13. Turn the compressor off. Instruct patient to The medication may dilate airways facilitating
take several deep breaths and cough to clear any expectoration of secretions.
secretions he/she might have his/her lungs. Also
instruct patient to cough the secretions into a
tissue and dispose of it properly then wash
hands.
D. FOLLOW-UP PHASE:
14. Record medication given and the description Documentation provides continuity of care.
of secretions and side-effects if any. Proper documentation is a proof of work done
and observed.

REFERENCE:
Fundamentals of Nursing by: Kozier
 NCM 109 RLE – CARE OF MOTHER, CHILD, AT RISK OR WITH PROBLEMS (ACUTE AND CHRONIC)
PERFORMANCE RATING SCALE
NEBULIZATION

SCALE DESCRIPTION INDICATORS

4 Very Good Student performs behaviors/tasks reflecting the highest level of
performance: consistent, independent, effective
3 Good Student performs behaviors/tasks reflecting mastery of performance
with minimal supervision
2 Fair Student performs behaviors/tasks reflecting development and
movement towards mastery of performance with help or direct
supervision in some aspect
1 Needs Student performs behaviors/tasks reflecting beginning level of
Improvement performance; tasks not done properly majority of the time but
demonstrate understanding of concepts involved with tasks

DEFINITION: A method of administering a drug by spraying it into the respiratory passages of

the patient. The medication may be given with or without oxygen to help carry it into the lungs.

PURPOSES:
• To open the collapse alveoli and deliver medicated aerosol therapy.
• To relieve patient from having shortness of breath.
• Help expand the lungs thus loosen secretions.
• Commonly used at home on a long-term basis especially for those patients with Chronic
Obstructive Pulmonary Disease (COPD) to dispense inhaled medication.

INDICATIONS:
• Indicated to patient having difficulty in raising/expectorating respiratory secretions.
• Reduce vital capacity and less costly method of loosening secretions.
EQUIPMENT:
• Nebulizer machine
• Nebulizer kit/set (tubing, mouthpiece, manifold, mask)
• Syringe 3cc
• Saline solution (NSS)
• Air compressor, wall air, wall oxygen (O2 driven)
• Medication administration record
• Baffle (controls the air, helps in the convention)
• T-piece

PROCEDURE 4 3 2 1 REMARKS
A. PREPARATION OF MEDICATION
1. Place the air compressor on a sturdy surface. Plug the cord from
the compressor into a properly grounded (three prong) electrical
outlet.
2. Wash your hands with soap and warm water, and dry completely
with a clean towel.
3. Carefully measure the medicine exactly as you have been
instructed. Use a separate, clean measuring device (eyedropper
or syringe) for each medicine. Look the medication at eye level.
4. Remove the top part of the nebulizer cup as shown. Place your
medicine in the bottom of the nebulizer cup.
5. Cover the cup and fasten. Connect and fasten the mouthpiece/T-
piece or face mask to the cup. Then connect the tubing to both
the aerosol compressor and nebulizer cup.
B. PREPARATION OF THE PATIENT
6. Monitor patient’s heart rate before and after treatment.
7. Explain the procedure to the patient. This therapy depends on
patient’s effort.
8. Place the patient in a comfortable sitting or semi-fowler’s
position.
C. WORKING PHASE
9. Turn on the compressor with the on/off switch. Once you turn on
the compressor, you should see a light mist coming from the back
of the tube opposite the mouthpiece.
10. If using a mask, position it comfortably and securely on patient’s
face. If using a mouthpiece, instruct patient to place it between
teeth and seal lips around. Nose clips are sometimes used if the
patient has difficulty breathing through the mouth.
11. Instruct patient to take slow, deep breaths through your mouth.
If possible, let him/her hold each breath for two to three seconds
before breathing out until all the medication is nebulized.
12. Simultaneously do chest physiotherapy.
 13. Turn the compressor off. Instruct patient to take several deep
breaths and cough to clear any secretions he/she might have
his/her lungs. Also instruct patient to cough the secretions into a
tissue and dispose of it properly then wash hands.
D. FOLLOW-UP PHASE:
14. Record medication given and the description of secretions and
side-effects if any.

TOTAL 56 /

Actual Score/Total Score x 100

A (92 – 100)
A- (84 – 91.99)
B (76 – 83.99)
B- (68 – 75.99)
C (60 – 67.99)
F (< 60)

Student’s Signature : ________________________

Clinical Instructor’s Signature : ________________________