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Nebulization Therapy

Definition: Nebulization is the process by which a liquid medication

is converted into a fine mist that can be inhaled. The device that is

used to convert the liquid drug into aerosol droplets suitable for

patients to inhale is known as a “Nebulizer”. 

Purpose: Nebulization is a common method of medicinal aerosol

generation and it is largely used by adults and children all over the

world, both for emergency treatment of acute respiratory illness and

for long-term home treatment of airway diseases such as asthma,

chronic obstructive pulmonary disease (COPD) and cystic fibrosis.

Nebulizer effectively delivers the medicine directly into the respiratory

tract so that it can reach the lungs quickly and reverses the symptoms

of wheezing, coughing, and other breathing difficulties.

Method of inhalation with a nebulizer: The patient should be

instructed to sit upright, take steady breaths (tidal breathing), and to

not talk during the nebulization. Steady normal breathing interspersedwith occasional deep breaths is likely to be optimal. It should be noted

that the nasal passages effectively filter droplets delivered from the

nebulizer. Hence, oral breathing is preferred over nasal breathing. 

Clinical indications:

  In acute attacks of asthma or COPD exacerbations,

nebulization treatment is usually employed.

  Patients not able to or too sick or incapable of managing

handheld inhalers.

  Drugs not available in handheld inhaler (e.g.: Arformoterol,

N-Acetylcysteine)

  Need for a large drug dose.

  Patient preference: Many patients may prefer nebulization

therapy over other inhaler devices.

  Practical convenience.

Equipments needed:

a.  Air compressor / nebulizer unit

b.  Tubing

c.  Mouthpiece / face mask

d.  Nebule / medication as prescribed by physician

e.  Medication Card

Procedure:

ASSESSMENT:

1.  Monitors the client’s heart rate before the treatment

when using bronchodilator drugs.

PLANNING:

1.  Obtains client’s medication card. 

2.  Checks medication against physician’s order.

3.  Prepares the necessary equipment.

4.  Checks that the tubing and all components are clean.

5.  Places the nebulizer compressor on a table or on any

stable surface.

6.  Washes hands.

IMPLEMENTATION:

1.  Explains the procedure to the client.

2.  Places the patient in a comfortable sitting or semi-

fowlers position.

3.  Attaches the plastic tubing to the air pump outlet of the nebulizer compressor, making sure other end

tube is secured into hand-held nebulizer mouthpiece

or mask.

4.  Unscrews nebulizer cap and pours medication per

doctor’s order. Reattaches cap by turning clockwise.

5.  Plugs the nebulizer compressor unit to the electrical

outlet and turns it “ON” to begin the treatment. 

6.  Instructs the patient to exhale.

7.  Instructs the client to take deep breaths from the

mouthpiece (inhale, hold breath briefly then exhale).

8.  Observes expansion of the client’s chest to ascertain

deep-breathing.

9.  Instructs client to breath slowly and deeply until all

medication is nebulized.

10. Presses power switch “OFF” and unplugs the

nebulizer compressor unit from the electrical outlet

when treatment is finished.

11. Encourages client to cough after several deep

breaths upon completion of treatment.

12. Disassembles nebulizer chamber by turning counter

clockwise.

13. Cleans the component with warm water and

detergent solution and rinses with clean tap waterand air dry thoroughly.

14. Washes hands after the procedure.

EVALUATION:

  Monitors the client’s heart rate and response to the

nebulization therapy.

DOCUMENTATION:

  Records the medication used, client’s respiratoryrate and effort, heart rate pre and post treatment,

and description of secretion.

Prepared by: 

Rene John G. Francisco 

BN4-A