NEBULIZATION & CHEST PHYSIOTHERAPY

NEBULIZATION
- administration of medication through a medicated spray.
- used primarily for medications designed to ease respiratory distress symptoms such as those seen with asthma.

PURPOSES:
To add moisture to oxygen delivery systems To hydrate thick sputum and prevent mucus plugging To administer various drugs airways to the

2 KINDS OF NEBULIZATION
Atomization in atomization, a device called an atomizer produces large droplets for inhalation. Aerosolization the droplets are suspended in a gas, such as oxygen.

NEBULIZER
- is a device used to aerosolize medications into a mist for delivery directly into the lungs.

TYPES OF NEBULIZER

1.

Large Volume Nebulizer can provide a heated or cool mist it is used for long term therapy, such as that following a tracheostomy

TYPES OF NEBULIZER
2.

Ultrasonic Nebulizer provides 100% humidity and can provide particles small enough to be inhaled deeply into the respiratory tract

TYPES OF NEBULIZER
3.

Jet Nebulizer are connected by tubing to a compressed air source that causes air to blast at high velocity through a liquid medicine to turn it into an aerosol, which is then inhaled by the patient.

TYPES OF NEBULIZER
4.

Metered Dose Inhaler

a handheld nebulizer, is a pressurized container of medication that can be used by the client to release the medication through a nosepiece or mouthpiece

INDICATIONS
It

is medically necessary to administer betaadrenergics, anticholinergics, corticosteroids, and cromolyn for the management of obstructive pulmonary disease. is medically necessary to administer gentamycin, tobramycin, amikacin, or dormase alpha to a patient with cystic fibrosis.

It

INDICATIONS
It

is medically necessary to administer pentamidine to patients with HIV pneumocystosis and complications for organ transplants.

It

is medically necessary to administer mucolytics (other than dormase alpha) for persistent thick or tenacious pulmonary secretions.

CONTRAINDICATIONS
6

treatments within the past 2 hours

Allergy

to Albuterol (Ventolin, Proventil) or Atrovent (Ipratropine Bromide)

> 170/minute > 160/100 mm Hg

HR BP

Common

MAO inhibitors for Albuterol: Nardil, Danate, and Marplan

ASSESSMENT
Assess

clients medical history, history of allergies and medication history. clients ability to assemble, hold and manipulate the nebulizer equipment.

Assess

ASSESSMENT
Assess

drug ordered, including amount, type, amount of diluent (if unit dose is not available) and frequency. pulse, respiration, and breathe sounds before beginning treatment.

Assess

EQUIPMENTS
Medication

ordered

EQUIPMENTS
Medication

ordered Diluent (if needed)

EQUIPMENTS
Medication

ordered Diluent (if needed) Nebulizer bottle and tubing assembly

EQUIPMENTS
Medication

ordered Diluent (if needed) Nebulizer bottle and tubing assembly Small-volume nebulizer machine

EQUIPMENTS
Medication

ordered Diluent (if needed) Nebulizer bottle and tubing assembly Small-volume nebulizer machine Stethoscope

PROCEDURE
1.

Verify the doctors order.

PROCEDURE
1. 2.

Verify the doctors order. Gather the equipments needed.

PROCEDURE
1. 2. 3.

Verify the doctors order. Gather the equipments needed. Identify the patient.

PROCEDURE
1. 2. 3.

Verify the doctors order. Gather the equipments needed. Identify the patient.

4.

Explain the use of nebulizer and describe possible drug side effects.

PROCEDURE
5.

Assemble the nebulizer equipment per manufacturers direction Add the prescribed medication and diluents (if needed) to the nebulizer.

6.

PROCEDURE
7.

Have client hold the mouthpiece between the lips with gentle measure. Have client take a deep breath, slowly, to a volume slightly greater than normal. After inspiration have the pause briefly, and then have the client exhale passively.

8.

PROCEDURE
9.

Turn on the small-volume nebulizer machine, and ensure that a sufficient mist is formed. When a medication is completely nebulized and liquid is gone, turn off the machine and store tubing assembly per agency policy.

10.

PROCEDURE
11.

If steroids are nebulized, encourage patient to rinse mouth and gargle with warm water after nebulizer treatment. Check PR, BP, and RR at the end of treatment.

12.

PROCEDURE
13.

Assist patient to a comfortable position.

Wash your hands. Necessary aftercare.

14.

15.

UNEXPECTED OUTCOMES
Clients

breathing pattern is Respiration is rapid and shallow.

ineffective.

Client Client

experiences paroxysms of coughing.

experiences cardiac dysrythmias. Client may experience side effects from medications.

UNEXPECTED OUTCOMES
Client

is unable to self-administer medication properly. is unable to explain technique and risk of drug therapy.

Client

DOCUMENTATION
Record

the drug used, the dosage and concentration, time and date of administration.
the clients baseline PR, RR, and breathe sounds.

Record

DOCUMENTATION
Record

the clients response to the medications including PR, RR, and breathe sounds assessed.
taught and clients ability to perform

Skills

them.