Nebulization Therapy

 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.