NEBULIZATION
and
STEAM INHALATION
Purpose:
 To loosen secretions and stimulate
expectorations
 To relieve upper respiratory tract edema
and congestion
 To relieve irritation (throat tickle) by
moistening the air
 To relax muscles and thus relieves
coughing
Assessment:
 Patient’s respiratory status and
secretions
 Drug allergy
 Patient’s risk for injury
   Level of Understanding
           NEBULIZATION
   Process of adding moisture or
    medications to inspired air by mixing
    particles of varying sizes with the air.
NEBULIZERS
 Nebulizers deliver most medications
administered through the inhaled
route.
 Used to deliver a fine spray (fog/ mist)
of medication or moisture to a client.
Two Kinds of Nebulization:
ATOMIZATION- a device called an atomizer
produces large droplets for inhalation.
 AEROSOLIZATION- droplets are suspended
in a gas, such as oxygen.
ATOMIZER
 LARGE- VOLUME NEBULIZER - can provide
a heated or cool mist.
ULTRASONIC NEBULIZER - provides 100%
humidity and can provide particles small
enough to be inhaled deeply into the
  respiratory tract
 METERED-DOSE INHALER - a hand held
nebulizer, is a pressurized container of
medication that can be used by the client
to release the medication through a
nosepiece/ mouthpiece
  PROCEDURE:
1. Determine the need for nebulization
2. Check doctor’s order
3. Inform the patient about the
   procedure (give explanations)
4. Gather necessary materials
MATERIALS:
 Nebulizer
 Medication
 Canister and tubings
   Saline solution
5. Wash hands
6. Prepare the client for the procedure
   and assist in positioning (or if there is
   support person)
    POSITION: Comfortable sitting or
    semi-fowler’s position
7. Set-up the nebulizer. Ensure proper
   functioning.
   a. Connect the nebulizer to the
  connecting tubing
  b. Fill the canister with medication or
    saline solution with the medication
8. Turn on to start the nebulization.
    a. Direct the canister towards patient’s
   mouth and instruct patient to take in a
   deep breath from the mouthpiece
9. Assist client for effective inhalation of the
steam
10. Tap the canister from time to time until the
  medicine is consumed.
11. Make the patient comfortable and encourage
    coughing after treatment.
12. Thank the patient.
13. Clean the materials and return to proper
  place.
14. Wash Hands.
DOCUMENTATION
 Procedure
 Time and Date
 Patient’s respiratory status
 Effectiveness of the procedure
 Patient’s response or any significant
findings
    STEAM INHALATION
 Inhalation of warm, moist air
into the mucous membranes
  and respiratory tract.
PROCEDURE:
1.   Determine the need for steam
     inhalation.
2.   Verify doctor’s order.
3.   Inform the patient about the
     procedure.
4. Gather necessary materials:
  a. Steam inhalator machine (if
  available)
  b. Eye cover (damp face towel)
5. Wash Hands
6. Position patient to facilitate inhalation
of the steam.
7. Set- up apparatus for its water level
and ensure proper functioning.
4. urn on to start the steam inhalation.
5. Assist client for effective inhalation.
6. Instruct to take slow deep breaths
    Prescribed period of time: 15 - 20 mins.
7. Encourage coughing after treatment.
8. Clean the materials and return to proper
   place.
9. Wash Hands.
Alternative Way: (30 mins- 1hr)
  Materials:
   Boiling water in a kettle
   Vicks Vaporub ointment or Camphor oil
   Old newspaper
   Umbrella
   Sheets
   Paper bag
1.   Fill up kettle with just below the level of the
     spout and bring the water to boiling point.
     Add 1tsp of medication (Vicks) into the boiling
     water.
2.   Carry the stove and the kettle with caution
     near the bedside of the patient, if the patient
     is unable to stand or sit on the chair.
3.   If a croup tent is indicated, open an umbrella
     over the head of the patient and cover it with
     a sheet to form a tent.
 . With a newspaper or hard paper
  (folder), make a cylindrical tube to direct
  the steam into the tent away from the
  patient’s face.
5. If the patient is able to sit on the chair,
  he may sit near the stove in the kitchen.
Precautions:
 Avoid all risks of burning
 Avoid drafts during time of treatment.
Close windows near the patient.
 Extra care must be observed when
giving treatment to children and
  restless patients to avoid scalding.
METERED-DOSE INHALER
    METERED-DOSE INHALER
 A metered-dose inhaler, called an MDI
for short, is a pressurized inhaler that
delivers medication by using a
propellant spray.
              To use an MDI:
 Shake the inhaler well before use (3 or 4
shakes)
 Remove the cap
 Breathe out, away from your inhaler
 Bring the inhaler to your mouth. Place it in
your mouth between your teeth and close
you mouth around it.
 Start to breathe in slowly. Press the top of
  you inhaler once and keep breathing in slowly
  until you have taken a full breath.
 Remove the inhaler from your mouth, and hold
your breath for about 10 seconds, then breathe
  out.
 If you need a second puff, wait 30 seconds, shake
your inhaler again, and repeat steps 3-6. After
you've used your MDI, rinse out your mouth and
record the number of doses taken.
 Store all puffers at room temperature
“I never see what has been done; I
only see what remains to be done.”
                            -Buddh
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