nebulization AND NURSING MANAGEMENT (1).pptx

NEBULIZATIO
N
Presented by -
Mrs. Khushnasib
Associate Professor

DEFINITION
• Process of dispersing a liquid (medication)
into microscopic particles and delivering
into lungs as patient inhales through the
nebulizer.
• It is used to liquefy and remove
retained secretions from the respiratory
tract.

⚫Most aerosol medication have broncho
dilating effects and are administered
by respiratory therapy personnel.

PURPOSES
• To relieve respiratory insufficiency due to
broncho spasm.
• To correct the underlying respiratory disorders
responsible for broncho spasm.
• To liquefy and remove retained thick
secretions.
• To reduce inflammatory and allergic responses
of the upper respiratory tract.

• To correct humidify deficit resulting from
inspired air by passing the airway during the
use of mechanical ventilation in critically
and post surgical patents.
• When a person has a acute asthma attack.
• When a person is in respiratory distress.
• If a person is unable to use a inhaler.

• If a person has stridor.
• Respiratory congestions
• Pneumonia
• Atelectasis
• Asthma

HISTORY
• The first "powered" or pressurized inhaler
was invented in France by Sales-Girons in
1858. This device used pressure to atomize
the
liquid medication. The pump handle is
operated like a bicycle pump. When the pump
is pulled up, it draws liquid from the reservoir,
and upon the force of the user's hand, the
liquid is pressurized through an atomizer, to
be sprayed out for inhalation near the user's
mouth.

• In 1864, the first steam-driven nebulizer
was invented in Germany. This inhaler,
known as "Siegle’s steam spray inhaler”.
• The first electrical nebulizer was invented
in the 1930s and called a Pneumostat.

BERNOULIIS PRINCIPLE:
• By the mid 19th century the search was on for a device that
would turn a solution into a spray. It was believed that
such a device would break down the solution into atoms,
and in this way the solution could be inhaled. This
breakdown was thus referred to as atomization, pulverizing
or nebulizing, and the devices created were often referred to
as atomizers, pulverizers or nebulizers.
• Yet no such machine would have been invented if not for
the discovery of the Bernoulli Principle. Daniel Bernoulli
observed that when water hits a rock it creates a mist
that can be inhaled. He published a book in 1738 where
he described that a similar effect could be created by
forcing water through a narrow tube.

• His concept was based on the fact that the faster water flows
through a tube, the less the lateral pressure will be. A
decreased lateral pressure is also referred to as a negative
side stream pressure. If
there is a hole in the side of the tube, the negative pressure
will force water into the stream.
• This same concept was used in creating the first nebulizers,
only using air. Air is forced through a tube, and a hole in
the tube is connected to a container with a solution in it that
contains the medication. The fluid is basically sucked in
due to the negative sidewall pressure, and turned into a
spray or mist.

TYPES OF NEBULIZER:
• Inhaler or meterd-dose
nebulizer
• Jet nebulizer
• Ultrasonic nebulizer

FUNCTION:
• A nebulizer is a device that uses a small
compressor to convert liquid medication
into tiny droplets of mist that can be inhaled
directly into the lungs.
• Since the medication goes straight to the
lungs, onset of the medication’s action often
takes place rapidly.

• This promotes quick symptom relief in the
case of illnesses such as asthma, where
fast relief is desirable.
• Also, it minimizes the risk of side effects
of the medication, preventing the
medication from being metabolized into a
less effective form by the body.

EQUIPMENTS:
• Nebulizer and nebulizer connecting
tube
• Mouthpiece/mask
• Respiratory medication to
be administered
• Normal saline solution
• Sterile water
• Cotton balls

• Face mask
• Sputum mug with disinfectant
• Disposable tissues
• Kidney tray
• Medication card

SNO. PROCEDURE RATIONALE
1. Identify patient and check
physician’s instructions.
Ensures that the right procedure
has
been done for the patent.
2. Monitor heart rate before and after
the treatment for patients
using bronchodilator drugs.
Drugs may cause tachycardia
palpitation, dizziness, nausea,
or nervousness
3. Explain the procedure to
the
patient. This therapy depends
on the patient’s effort.
Proper explanation of the
procedure
helps to ensure patient’s
cooperation and effectiveness of the
treatment.
4. Place the pt in a
comfortable
sitting or a semi fowlers position.
Diaphragmatic excursion and lung
compliance are greater in this position.
This ensures maximal distribution and
deposition of aerosolized particles tp
the base of lungs.

5. Add the prescribed amount of
medications to the medicine chamber of
the tubing. Connect the tube to the
compressor.
A fine mist from the device should be
visible.
Aerosol particles enable
deep
penetration into tracheobronchial
tree.
6. Place the mask on patient’s face to cover
his mouth and nose and instruct him to
inhale deeply and slowly through mouth,
hold breath and then exhale several
times.
This encourages
optimal
dispersion of the medication.
7. Observe expansion of chest to ascertain
that patient is taking deep breaths.
This will ensure that
the
medication is deposited below the
level in the oropharynx.
8. Instruct the pt to breath slowly
and
deeply until all the medications is
nebulized.
Medication will usually
be
nebulized within 15 mins.

9. On completion of the treatment
encourage the patient to cough
after several deep breaths.
The medication may dilate airways
facilitating expectoration
of secretions.
10. Observe the pt for any adverse reaction
to the treatments.
Patient may
develop
bronchospasms due to inhalation of
aerosol.
The fluid may also cause dried and
retained secretions in airways,
leading to narrowing of the airway.
11. Document the medication used and the
description of the secretions
expectorated.
Proper documentation is a proof of
work done and observed.
12. Disassemble and clean nebulizer after
each use. Keep the equipment in pt’s
room. Tubing’s to be changed in every
48hrs.
Proper cleaning, sterilization
and
storage of equipments
prevents organisms from entering
the lungs.
13. Wash hands.

PROCEDURE:
1.Position the patient appropriately, allowing
optimal ventilation. (semi fowlers
position)
2.Assess and record breath sounds,
respiratory status, pulse rate and other
significant respiratory functions.
3.Teach patient the proper way of inhalation.

4. Prepare equipments at hand
5. Check doctor’s orders for the medication, prepare
thereafter
6. Place the medication in the nebulizer (can add a
amount of saline solution if ordered)
7. Attach the nebulizer to the compressed gas
source
8. Attach the connecting tubes and mouthpiece to
the nebulizer

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.

AFTER CARE
• Each time it is used, wash the nebulizer
chamber in warm water or clean with a
spirit swab and then rinse thoroughly with
clean water. Do not use a brush to clean the
nebulizer chamber as it may damage it.
• Reconnect the nebulizer chamber to
the tubing and blow air from it.

• This will dry the nebulizer chamber and
tubing. Disconnect the nebulizer chamber
from the tubing and allow it to dry
completely. Disconnect the tubing from the
compressor unit.

SIDE EFFECTS
• Dry or irritated throat, temporary or
occasional cough
• Sneezing, stuffy or itchy nose, watery eyes.
• Burning or bleeding of your nose
• Nausea, heartburn, stomach pain.

• Urinating more or less than usual.
• Dizziness, drowsiness, headache.
• Unusual or unpleasant taste in your
mouth.

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)

nebulization AND NURSING MANAGEMENT (1).pptx

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nebulization AND NURSING MANAGEMENT (1).pptx