Learning Outcomes

Content Outlines

At the end of eight (8) hours lecture and skills demonstration, the student will be able to: 1. Define nebulization Nebulization is the process by which a liquid medication is therapy. 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. 2. State the purpose Nebulization is a common method of medicinal aerosol of nebulization generation and it is largely used by adults and children all over therapy. 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. 3. State the advantages a. It does not require coordination between inspiration and of nebulization therapy. actuation as it uses normal tidal breathing. b. It is the most convenient way of delivering high doses of inhaled medication. c. In acute severe asthma, oxygen can be used to nebulize the drug. d. Only 2% of the aerosol from the nebulizer is deposited in the mouth, compared to 60-80% oral deposition from metered dose inhaler (MDI) (when not using a spacer device).

Teaching-Learning Activities Teacher Student Activities Activities The teacher: The learners will be:

Time Allotment

Resources & Materials

Evaluation & Expected Outcome Learners will be able to:

Defines and discusses what nebulization therapy is. States the purpose of nebulization therapy.

Asked to 10 minutes (Internet) participate in the Power point discussion. presentation.

Define in their own words the meaning of nebulization therapy. Asked to 10 minutes (Internet) State their participate understanding in the Power point on the purpose discussion. presentation. of nebulization therapy.

States the advantages of nebulization therapy.

Asked to 10 minutes (Internet) participate in the Power point discussion. presentation.

Verbalize their understanding on the advantages of nebulization therapy.

4. State the method of inhalation with a nebulizer.

5. State the clinical indications for the use of nebulization therapy.

6. Enumerate the equipments needed.

7. Demonstrate the beginning skills in the performance of nebulization therapy correctly.

e. It can be used by any age group. The patient should be instructed to sit upright, take steady breaths (tidal breathing), and to not talk during the nebulization. Steady normal breathing interspersed with 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. a. In acute attacks of asthma or COPD exacerbations, nebulization treatment is usually employed. b. Patients not able to or too sick or incapable of managing handheld inhalers. c. Drugs not available in handheld inhaler (e.g.: Arformoterol, NAcetylcysteine) d. Need for a large drug dose. e. Patient preference: Many patients may prefer nebulization therapy over other inhaler devices. f. Practical convenience. The necessary equipments for nebulization therapy are: a. Air compressor / nebulizer unit b. Tubing c. Mouthpiece / face mask d. Nebule / medication as prescribed by physician e. Medication Card ASSESSMENT: 1. Monitors the clients heart rate before the treatment when using bronchodilator drugs. PLANNING: 2. Obtains clients medication card. 3. Checks medication against physicians order. 4. Prepares the necessary equipment. 5. Checks that the tubing and all components are clean.

States the methods of inhalation with a nebulizer. States the clinical indication for the use of nebulization therapy.

Asked to 10 minutes (Internet) participate in the Power point discussion. presentation.

State the method of inhalation with a nebulizer.

Asked to 10 minutes (Internet) participate in the Power point discussion. presentation.

State their understanding on the indications of the procedure.

Enumerates Asked to 10 minutes the necessary familiarize equipments. the necessary equipments. Demonstrates the procedure correctly. Asked to participate in the discussion and demonstrate the procedures 7 hours

(Internet) Facilities and necessary equipments. (Internet) Facilities and necessary equipments.

Enumerate equipments needed.

all

Create a mental model of the procedure for mastery and deliver the nebulization therapy procedure

6. Places the nebulizer compressor on a table or on any stable surface. 7. Washes hands. IMPLEMENTATION: 8. Explains the procedure to the client. 9. Places the patient in a comfortable sitting or semifowlers position. 10. 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. 11. Unscrews nebulizer cap and pours medication per doctors order. Reattaches cap by turning clockwise. 12. Plugs the nebulizer compressor unit to the electrical outlet and turns it ON to begin the treatment. 13. Instructs the patient to exhale. 14. Instructs the client to take deep breaths from the mouthpiece (inhale, hold breath briefly then exhale). 15. Observes expansion of the clients chest to ascertain deep-breathing. 16. Instructs client to breath slowly and deeply until all medication is nebulized. 17. Presses power switch OFF and unplugs the nebulizer compressor unit from the electrical outlet when treatment is finished. 18. Encourages client to cough after several deep breaths upon completion of treatment. 19. Disassembles nebulizer chamber by turning counter clockwise. 20. Cleans the component with warm water and detergent solution and rinses with clean tap water and air dry thoroughly.

one by one.

correctly, after adequate time of supervised demonstration and practice.

Competency of the performance will be evaluated using the prepared performance checklist. Note: For every number or procedure, the learner is graded by putting a check mark either under 0, 1 or 2 column. Total number of check marks are summed up according to its corresponding weight, either 1 or 2. Passing Score is 50 % of

21. Washes hands after the procedure. EVALUATION: 22. Monitors the clients heart rate and response to the nebulization therapy. DOCUMENTATION: 23. Records the medication used, clients respiratory rate and effort, heart rate pre and post treatment, and description of secretion.

the total number of items in the procedure.

Prepared by:

Noted and Approved by:

Jonalyn T. Padua, R.N., R.M.

Instructor NED Professor