Chapter 6. Non-Parenteral Medication Administration
6.6 Administering Inhaled Medications
Medications administered through inhalation are dispersed via an aerosol spray, mist, or powder that patients inhale into their airways. Although the primary effect of inhaled medications is respiratory, there are likely to be systemic effects as well. Most patients taking medication by inhaler have asthma or chronic respiratory disease and should learn how to administer these medications independently. A variety of inhalers are available, and specific manufacturers’ instructions should always be followed to ensure appropriate dosing.
Administering Medication by Small-Volume Nebulizers
Nebulization is a process by which medications are added to inspired air and converted into a mist that is then inhaled by the patient into their respiratory system (Lilley et al., 2016; Perry et al., 2018). (See Figure 6.20 and 6.21) The air droplets are finer than those created by metered dose inhalers, and delivery of the nebulized medication is by face mask or a mouthpiece held between the patient’s teeth.
Checklist 52 outlines the steps for delivering medication through a small-volume nebulizer.
Checklist 52: Medication by Small-Volume NebulizerDisclaimer: Always review and follow your agency policy regarding this specific skill.
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Safety considerations:
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Steps |
Additional Information |
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| 1. Perform hand hygiene before medication preparation.
Check MAR to guide you to which medications you are preparing. Follow agency policy to ensure MARs are accurate and verified appropriately. |
A MAR that is checked by more than one healthcare professional provides a very reliable record for administering medications. Agencies may vary in relation to MAR verification processes. |
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2 a. As you are removing medications from the dispensing system, perform the SEVEN rights three times with each individual medication:
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The right patient: Check that you have the correct patient using two patient identifiers (e.g., name and date of birth).
The right medication (drug): Check that you have the correct medication and that it is appropriate for the patient in the current context. The right dose: Check that the dose makes sense for the age, size, and condition of the patient. Different dosages may be indicated for different conditions. The right route: Check that the route is appropriate for the patient’s current condition. The right time: Adhere to the prescribed dose and schedule. The right reason: Check that the patient is receiving the medication for the appropriate reason. The right documentation: Always verify any unclear or inaccurate documentation prior to administering medications. |
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2 b. The label on the medication must be checked for name, dose, and route, and compared with the MAR at three different times:
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Whenever possible, take the MARs to the bedside to complete the third check. |
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| 3. Assemble nebulizer apparatus as per manufacturer’s instructions. | Assemb