Chapter 6. Non-Parenteral Medication Administration Show
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 themselves. A variety of inhalers are available, and specific manufacturers’ instructions should always be checked and followed to ensure appropriate dosing. Medication by Small-Volume NebulizersNebulization 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., 2011; Perry et al., 2014.) (see Figure 6.4). 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. Figure 6.4 Example of a small-volume nebulizerChecklist 51 outlines the steps for delivering medication through a small-volume nebulizer. Checklist 51: Medication by Small-Volume Nebulizer
Medication by Metered Dose Inhaler (MDI)A metered dose inhaler (MDI) is a small handheld device that disperses medication into the airways via an aerosol spray or mist through the activation of a propellant. A measured dose of the drug is delivered with each push of a canister, and dosing is usually achieved with one or two puffs. Examples of MDIs, with a spacer on the rightChecklist 52 lists the steps for administering medication by MDI.
What inhaler should be administered first?If you use more than one inhaled medicine at a time, use the bron- chodilator (“reliever”) first. This opens up the breathing tubes so the other medications can get to the lungs better.
What comes first fluticasone or albuterol?First administer the Albuterol, and then 5 minutes later administer the Fluticasone. For this particular scenario, we know that our patient has asthma and is prescribed by the physician to use two metered-dose inhalers (Fluticasone and Albuterol).
Which inhaler should the nurse be prepared to administer to a client at the onset of an asthma attack?All asthma attacks require treatment with a quick-acting (rescue) inhaler such as albuterol. One of the key steps in preventing an asthma attack is to avoid your triggers.
Which as needed medication should be administered first in the patient with acute asthma symptoms?Corticosteroids. A dose of systemic corticosteroids should be administered within the first hour of treatment for acute asthma for all but patients with the mildest form of the disease.
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