The document discusses administering medications for respiratory issues through metered-dose inhalers and nebulization therapy. Metered-dose inhalers deliver short bursts of aerosolized medication for conditions like asthma. Nebulization therapy uses a nebulizer to create a mist from a drug solution for inhalation, allowing medications like bronchodilators to reach the lungs. It describes how to administer nebulization therapy safely and properly monitor patients for side effects.

1. ADMINISTERING
MEDICATIONS FOR
PATIENTS WITH
PROBLEMS RELATED TO
RESPIRATORY SYSTEM
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

2. OUTLINE
• USE OF MDI
• NEBULIZATION THERAPY
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

3. METERED-DOSE INHALER (MDI)
• A DEVICE THAT DELIVERS A SPECIFIC AMOUNT OF
MEDICATION TO THE LUNGS, IN THE FORM OF A SHORT
BURST OF AEROSOLIZED MEDICINE THAT IS USUALLY SELF-
ADMINISTERED BY THE PATIENT VIA INHALATION.
• IT IS THE MOST COMMONLY USED DELIVERY SYSTEM FOR
TREATING
ASTHMA, CHRONIC OBSTRUCTIVE PULMONARY
DISEASE (COPD) AND
OTHER RESPIRATORY DISEASES.
• THE MEDICATION IN A METERED DOSE INHALER IS MOST
COMMONLY A BRONCHODILATOR, CORTICOSTEROID OR A
COMBINATION OF BOTH FOR THE TREATMENT OF ASTHMA
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

4. Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

5. NEBULIZATION THERAPY
DEFINITION
• IS THE PROCESS OF MEDICATION ADMINISTRATION VIA
INHALATION. IT UTILIZES A NEBULIZER WHICH
TRANSPORTS MEDICATIONS TO THE LUNGS BY MEANS OF
MIST INHALATION.
• A NEBULIZER IS A SMALL DEVICE THAT CAN CONVERT A
DRUG FROM A SOLUTION INTO AN AEROSOL FORM BY
MEANS OF A COMPRESSOR/COMPRESSED GAS SOURCE.
• NEBULIZATION CREATES A MIST OF DRUG PARTICLES THAT
CAN BE INHALED VIA A FACE MASK OR MOUTHPIECE
SOOTHING THE INFLAMED AIRWAYS
• BRONCHODILATORS ARE THE MOST COMMON NEBULIZED
DRUGS BUT MANY OTHERS CAN BE NEBULIZED,
INCLUDING STEROIDS AND ANTIBIOTICS.
•
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

6. NEBULIZATION THERAPY
PURPOSE
• TO ADD MOISTURE TO OXYGEN DELIVERY
SYSTEM
• TO HYRDATE THICK SPUTUM AND PREVENT
MUCUS PLUGGING
• TO ADMINISTER VARIOUS DRUGS TO THE
AIRWAYS
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

7. MEDICATIONS ADMINISTERED
VIA NEBULIZER
• BRONCHODILATORS (FOR EXAMPLE, SALBUTAMOL),
• ANTICHOLINERGICS (FOR EXAMPLE, IPRATROPIUM BROMIDE),
• CORTICOSTEROIDS (FOR EXAMPLE, BECLOMETASONE)
• NORMAL SALINE.
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

8. INDICATION OF NEBULIZATION
NEBULIZATION THERAPY IS USED TO DELIVER MEDICATIONS ALONG THE
RESPIRATORY TRACT AND IS INDICATED TO VARIOUS RESPIRATORY PROBLEMS
AND DISEASES SUCH AS:
• BRONCHOSPASMS
• CHEST TIGHTNESS
• EXCESSIVE AND THICK MUCUS SECRETIONS
• RESPIRATORY CONGESTIONS
• PNEUMONIA
• ATELECTASIS
• ASTHMA
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

9. CONTRAINDICATIONS
IN SOME CASES, NEBULIZATION IS RESTRICTED OR AVOIDED DUE TO POSSIBLE
UNTOWARD RESULTS OR RATHER DECREASED EFFECTIVENESS SUCH AS:
• PATIENTS WITH UNSTABLE AND INCREASED BLOOD PRESSURE
• INDIVIDUALS WITH CARDIAC IRRITABILITY (MAY RESULT TO DYSRHYTHMIAS)
• PERSONS WITH INCREASED PULSES
• UNCONSCIOUS PATIENTS (INHALATION MAY BE DONE VIA MASK BUT THE
THERAPEUTIC EFFECT MAY BE SIGNIFICANTLY LOW)
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

10. EQUIPMENT
• NEBULIZER AND NEBULIZER CONNECTING TUBES
• COMPRESSOR OXYGEN TANK
• MOUTHPIECE/MASK
• RESPIRATORY MEDICATION TO BE ADMINISTERED
• NORMAL SALINE SOLUTION
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

11. POSSIBLE EFFECTS AND REACTIONS AFTER
NEBULIZATION THERAPY
• PALPITATIONS
• TREMORS
• TACHYCARDIA
• HEADACHE
• NAUSEA
• BRONCHOSPASMS (TOO MUCH VENTILATION MAY RESULT OR EXACERBATE
BRONCHOSPASMS)
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

12. CAUTION
• PATIENTS WITH COPD SHOULD HAVE NEBULIZERS DRIVEN BY AIR
(BMA/RPSGB, 2007).
• PATIENTS WITH ACUTE ASTHMA SHOULD HAVE NEBULIZERS DRIVEN BY
OXYGEN (USUALLY 6-8L/MIN
• IF A PATIENT WITH GLAUCOMA IS TO RECEIVE AN ANTICHOLINERGIC DRUG
SUCH AS IPRATROPIUM BROMIDE, A MOUTHPIECE IS PREFERRED AS THIS
REDUCES THE LEAKAGE OF NEBULISED SOLUTION INTO THE EYES (PORTER-
JONES, 2000).
• COMPRESSORS SHOULD BE SERVICED ON A REGULAR BASIS ACCORDING TO
LOCAL POLICY.
• LOCAL INFECTION CONTROL PROCEDURES SHOULD BE FOLLOWED TO
MINIMIZE THE RISK OF CROSS INFECTION.
•
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

13. HEALTHCARE PROVIDER’S ROLES
1. CLOSELY MONITOR ALL CLIENTS RECEIVING
BRONCHODILATORS FOR SIGNS OF INCREASED HEART RATE,
NERVOUS AGITATION AND RESTLESSNESS
2. PATIENT TEACHING
• PROPER WAY OF DOING THE THERAPY TO FACILITATE
EFFECTIVE RESULTS AND PREVENT COMPLICATIONS
(DEMONSTRATION IS VERY USEFUL
• EMPHASIZE COMPLIANCE TO THERAPY
• REPORT UNTOWARD SYMPTOMS IMMEDIATELY FOR
APPOSITE INTERVENTION.
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA

14. REFERENCES
• KOZIER & ERBS FUNDAMENTALS OF NURSING. EIGHTH ED.
• CRAVEN & HIRNLE. FUNDAMENTALS OF NURSING. HUMAN HEALTH AND
FUNCTION. LIPPINCOTT & WILLIAMS. FOURTH ED.
• NURSING CRIB
Presented by:
Dr. Joel John A. Dela Merced,
PhDN, DrHum, MSN, RN, CRN, DCE, CDCP, SHC1, CIN, CINP, CMHFR, LPT,
LMT,
DipHM, CHA, DPCHA, FPCHA, CQSPSQua, FPSQua, FRIN, FRIEdr, FRIRes,
FSASS, OPA