Nebulization -is the process of medication administration via inhalation.

It utilizes a nebulizer which transports medications to the lungs by means of mist inhalation. Nebulizers -are mechanical devices that provide a stream of moistened air directly into the respiratory tract. Nebulizer therapy -aids bronchial hygiene by restoring and maintaining mucus blanket continuity, hydrating dried secretions, promoting secretion expectoration, humidifying inspired oxygen, and delivering drugs. Purpose: 1. To relieve respiratory insufficiency due to bronchospasm 2. To correct the underlying respiratory disorders responsible for bronchospasm 3. To liquefy and remove retained thick secretion form the lower respiratory tract 4. To reduce inflammatory and allergic responses the upper respiratory tract 5. To correct humidify deficit resulting from inspired air by passing the airway during the use of mechanical ventilation in critically and post surgical patients 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

Nursing procedure: 1. Monitor the heart rate before and after the treatments or patients using bronchodilator drugs. 2. Explain procedure to the patient. 3. Position the patient appropriately, allowing optimal ventilation. 4. Assess and record breath sounds, respiratory status, pulse rate and other significant respiratory functions. 5. 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

6. Prepare equipments at hand 7. Check doctors orders for the medication, prepare thereafter 8. Place the medication in the nebulizer while adding the amount of saline solution ordered. 9. Attach the nebulizer to the compressed gas source 10.Attach the connecting tubes and mouthpiece to the nebulizer 11.Turn the machine on (notice the mist produced by the nebulizer) 12.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 13.Continue until medication is consumed 14.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 15.Attend to possible side effects and inhalation reactions 16.Record medication used and description of secretions. 17.Disassemble nebulizers and clean after every use.

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)

Nursing Responsibilities: * Assist client during nebulization. * Instruct to administer the nebulization at exact time and interval. * Notify physician if there is paradoxic bronchospasm occur during the therapy * Instruct the patient to report any untoward reactions such as fast-breathing and

DOB. * Chestphysiotherapy every after nebulization. *Health teachings, 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.

TYPES OF NEBULIZERS Large volume nebulizers -such as Venturi Jet provide humidity for an artificial airway. Small volume nebulizer -such as Mini Nebulizer is used to deliver drugs such as bronchodilators. Ultrasonic nebulizers -are electrically driven and use high-frequency vibrations to break up surface water into particles; resultant dense mist can penetrate smaller airways, hydrate secretions, and induce coughing. In line nebulizers are used to deliver drugs to patients being mechanically ventilated