ADMINISTERING NEBULIZER

MEDICATION

PURPOSE:
- delivers an inhaled dose of medication into the mucosa and
bloodstream to ease respiratory distress

EQUIPMENT
Hand-held nebulizer
- nebulizer set (cup, tubing, cap, mouthpiece or mask)
- medication (s)
- saline
- air compressor, wall oxygen
Metered-dose inhaler
PROCEDURE:
Using a hand-held nebulizer
1. Explain to the client the process of using the
nebulizer
- promotes compliance
2. Check the physician’s orders
- ensures that the right dose is administered to the
right client
3. Perform hand hygiene
- Decreases spread of microorganisms
4. Pour the entire dose of the drug into the nebulizer
cup
- Ensures accurate dosing of drug
5. Cover the cup with cap and fasten the mouthpiece
to the cap. Do not touch the interior parts of the masks
or mouthpiece
- Provides dead space to prevent room air from
entering system and medicated aerosol from
escaping; prevents introduction of organisms
6. Attach tubing to the bottom of the nebulizer cup
and attach the other end to the compressed air source
- Provides conduit for compressed air
7. Adjust wall oxygen to 6 L/min or less as ordered and turn
air on until medication begins to mist. Leave the air on for
about 6 or 7 minutes, until all of the medication is inhaled
- Delivers a low dose of oxygen with treatment; air flows
drives medication into aerosolized form
8. Instruct the client to breathe with lips tightly sealed around
the mouthpiece; if a mask is used, ensure that the mask is
properly applied to the client’s face and encourage the
client to take slow, deep breaths in through the mouth and
out through the nose
- Promotes efficacy of medication; increases delivery of
medication into lungs
9. When medication is complete, perform hand hygiene and
don gloves
- Reduces transmission of microorganisms
10. Detach tubing from compressed air source and
nebulizer cup. If nebulizer is disposable, dispose
of nebulizer in appropriate container. If nebulizer
is to be reused, carefully wash with soapy water,
rinse, and dry nebulizer components
- Reduces transmission of microorganisms
11. Observe client for several minutes to assess
response to medication
- notes possible adverse reactions
12. Remove gloves and perform hand hygiene
- reduces microorganism transfer
13. Document procedure appropriately
- Serves as a legal record of medication
administration
Administering Metered-dose inhalation
1. Remove cap and hold inhaler upright
- allows proper administration of drug
2. Shake inhaler
- mixes medication well
3. Instruct client to tilt head back slightly and
breathe out
- Allows proper medication administration
4. Position inhaler in client’s mouth with lips
sealed around mouthpiece
- Allows proper medication administration
5. Press down on the inhaler to release medication as
client starts to breathe in. Instruct client to breathe
in slowly
- delivers medication to lungs
6. Instruct client to breathe in slowly over 3 to 5
seconds. If a second puff is ordered, repeat
administration after client fully exhales with the first
administration. If the medication is a dry powder
capsule, have the client close the mouth tightly
around the mouthpiece and inhale rapidly
- Promotes medication distribution to lungs;
administers full treatment; prevents loss of
medication
7. Recap medication and store appropriately
- Allows for future use
8. Observe client for several minutes to assess
response to medication
- Notes possible adverse reactions
9. Remove gloves and perform hand hygiene
- Reduces microorganism transfer
10. Document procedure appropriately
- Serves as legal record of medication
administration