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Nursing ProcedureNEBULIZATION THERAPY

NEBULIZATION THERAPY

NEBULIZATION THERAPY – Purpose, Jet Medication Nebulizer, Ultrasonic Nebulizer, Equipment and Procedure

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Nebulization Therapy

Nebulization therapy is to liquefy and remove retained secretions from the respiratory tract. A nebulizer is a device that produces a stable aerosol of fluid and/or drug particles.

PURPOSE

  • To relieve respiratory insufficiency due to bronchospasm
  • To correct the underlying respiratory disorders responsible for bronchospasm
  • To liquefy and remove retained thick secretion from the lower respiratory tract
  • To reduce inflammatory and allergic responses the upper respiratory tract
  • To correct humidify deficit resulting from inspired air by passing the upper airway during the use of mechanical ventilators in critically ill and post-surgical patients

TYPES

  • Jet nebulizers
  • Ultrasonic nebulizer

JET MEDICATION NEBULIZER

A jet medications nebulizers utilize a high velocity gas flew to generate practice from the prescribed solution either O2 of compressed air powers the nebulae.

EQUIPMENT

  • O2 cylinder/wall O2 outlet of flew metals
  • A clean tray with O2 nipple adapted to bit the connection tubing

Nebulizer kit consent of:  (face mask/mouth piece)

Nebulized jet and nebulizer cap O2 supply tubing

  • Physician orders
  • Prescribed nebulizer solution
  • The 0.9% NaCl ampoules as diluent if prescribed
  • A 5 ml syringe with needle
  • Disposable spectrum cup
  • Box of disposable leisters

PROCEDURE

  • Unscrew the nebulizer jar and instill the prescribed dose of solutions
  • Rescrew cap on nebulizer jar
  • Connect one end of the O2 tubing to the nebulizer and attach the other end of the supply tubing to the O2  flew maters
  • Place the patient in a comfortable sitting on semi-Fowler’s positions
  • Adjust the O2 to flow rate 5 to 6 units per minute or until a fine must appears
  • Place the mask snugly over the patients face to cover the nose, mouth and chin and adjust the elastic sharp around the patients
  • Instruct the patient to take deep breath, repeat hold breath briefly this exhale unit all the medications is nebulized
  • Observe expansion of the patient chest during therapy
  • Observe the patient. Though out the procedure and give constant reassurance
  • Thin oil the O2 when all the solution has vaporized and remove the face mask
  • Encourages the patient to length after several deep breaths
  • Assist the patient to a comfortable position and wipe off the moisture from the face to face with towel or disposable tissue
  • Dismantle the nebulizes kit and decontaminate in both soapy water

ULTRASONIC NEBULIZER

The ultrasonic nebulizer utilizes fluid contained in two chambers, which is rapidly vibrated, causing the fluid to breathe into small particles.

It works on the principles that high adequacy sound waves can break up water into aerosol particles by means of two transducers

EQUIPMENT

  • Ultrasonic equalizers and manufacturers instruction
  • Circulating set-up
  • Disposable aerosol mask
  • Sterile water
  • Physicians writes codes
  • Prescribed solution
  • Disposable sputum cup
  • Box of disposable tissue

PROCEDURE

  • Fill ultrasonic chamber, and the prescribed solution to the appropriate lay with sterile water
  • Assemble circulating according to manufacture instructions and plug the cord into an electrical outlet
  • Turn on the machine and adjust the selling until the described amount of mist is obtained
  • Position the client, in a comfortable sitting or semi-Fowler’s positions
  • Place the mask singly over the patient to cover the base
  • Observe the patient, for any adverse reaction to the treatment
  • Encourage the patient to partially cough and expectorate any secretions loosed during the treatment
  • Turn off the machine and discontinue the procedure
  • Remove the facemasks and decontaminate in hot soapy water
  • Wash and dry mask bands

PRELIMINARY ASSESSMENT

  • Check the general condition of the patient
  • Check the doctor’s orders
  • Check the correct position of the patient
  • Check the articles available in the patient unit

COMPLICATIONS

  • Combustion
  • CO2 necessaries
  • O2 toxicity
  • Absorption atelectasis
  • Infection
  • Chronic O2 therapy it home

POSTURAL DRAINAGE

DEFINITION

Drainage of secretion from lung segments by gravity utilizing specific positioning techniques

PURPOSE

  • To drain lung secretion before and after surgery
  • To aid for easy breathing in bronchial or lobar pneumonia, lung abscess
  • To treat patient with, e.g. bronchiectasis, chronic bronchitis and cystic fibrosis
  • To assist patient who are unable to cough and bring out sputum, via. Unconscious, debilitated, quadriplegic patient

EQUIPMENT

  • Pillows: 3:4
  • Sputum cup
  • Tissue paper
  • Sputum measuring glass

GENERAL INSTRUCTIONS

  • Perform postural drainage for patient  on empty stomach before meals
  • Avoid postural drainage for patient with hemoptysis

PROCEDURE

  • Explain purpose an procedure to patient
  • Locate affected lung with help of X-rays, auscultation and percussion
  • Administer bronchodilators before procedure
  • Give steam inhalation to patient after obtaining doctor’s written order
  • Position patient according to lung segment to be drained

Postural drainage techniques:

Upper lobes:

Upper segments: place patient in high Fowler’s position in chair or bed

Anterior segments: place patient in semi-Fowler’s position in chair or bed

Posterior segments: place patient in Fowler’s position in chair or bed, provide a cardiac table

Lateral segments: place patient in lateral position elevated to about 45 degree celcius, first to one side and then to other side. When out of bed ask patient to lean on arm, resting on chair or table for support.

Right middle lobes

      Anterior segment (right side): place patient flat on left side with a pillow under chest. Right shoulder and body are kept forward

Posterior segment: place patient in prone with chest and abdomen elevated

Lower lobes

    Anterior segments: place patient in supine, Trendelenburg with hips elevated with pillows, so that hips are higher than shoulders

Posterior segments: place patient prone, Trendelenburg or hips elevated with pillows so that hips are higher than shoulders

Lateral segments: place patient in right side lying

Trendelenburg for left lung and left side lying Trendelenburg for right lung or hips elevated with pillows to keep hips higher than shoulders

  • Perform chest percussions and vibrations on areas to be drained
  • Encourage patient to cough out secretions and collect in sputum container
  • Do suctioning if coughing is not possible
  • Make patient comfortable and ask to rest flat for ten to fifteen minutes before allowing sitting or getting out of bed
  • Dispose sputum container in infectious waste container. Replace articles
  • Document, time, amount and color of sputum drained, response of patient to therapy
NEBULIZATION THERAPY – Purpose, Jet Medication Nebulizer, Ultrasonic Nebulizer, Equipment and Procedure
NEBULIZATION THERAPY – Purpose, Jet Medication Nebulizer, Ultrasonic Nebulizer, Equipment and Procedure
NEBULIZATION THERAPY – Purpose, Jet Medication Nebulizer, Ultrasonic Nebulizer, Equipment and Procedure
NEBULIZATION THERAPY – Purpose, Jet Medication Nebulizer, Ultrasonic Nebulizer, Equipment and Procedure
NEBULIZATION THERAPY – Purpose, Jet Medication Nebulizer, Ultrasonic Nebulizer, Equipment and Procedure

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