Inhalation therapy involves the administration of medication directly into the respiratory tract through the airways. This route allows therapeutic agents to act locally in the lungs or enter the systemic circulation rapidly due to the vast surface area and rich blood supply of the alveolar membrane. By targeting the site of pathology directly, lower doses are often required compared to oral or intravenous routes, which minimizes systemic side effects. Drugs commonly delivered this way include bronchodilators, corticosteroids, and mucolytics, particularly for patients managing conditions like asthma, chronic obstructive pulmonary disease, or acute respiratory distress.
Various devices are used to deliver medication to the respiratory tract, each requiring specific patient techniques for optimal deposition.
Inhalation therapy is a cornerstone management strategy in both emergency and routine clinical care settings across Nigerian hospitals. Nurses administer these therapies to relieve acute bronchospasm, liquefy thick pulmonary secretions, reduce airway inflammation, and treat acute respiratory infections. Common clinical indicators include:
Thorough pre-administration assessment ensures safety and maximizes drug efficacy. The nurse must evaluate the patient's baseline respiratory status, including respiratory rate, depth, lung sounds, oxygen saturation, and level of consciousness. Assess the patient's manual dexterity and cognitive ability to choose the correct delivery device. Ensure the patient is in an upright, seated position to allow maximum chest expansion and lung volume. Check the medication order against the patient chart, verifying the exact drug, dose, and correct timing before proceeding with the treatment.
Executing inhalation therapy requires precision to ensure the medication reaches the lower airways. For an MDI, shake the canister, remove the cap, and have the patient exhale completely. Place the mouthpiece between the teeth with lips sealed tightly around it, avoiding tongue obstruction. Press down firmly on the canister once while taking a slow, deep breath lasting about five seconds. Instruct the patient to hold their breath for ten seconds, or as long as comfortably possible, to allow particles to settle, then exhale slowly through pursed lips. If a corticosteroid was administered, instruct the patient to rinse their mouth with water and spit it out to prevent oral candidiasis.
Although generally safe, inhalation therapy carries specific risks that nurses must monitor. Overuse of short-acting beta-agonists can lead to tachycardia, palpitations, and nervous tremors. Improper cleaning of nebulizer masks and tubing can harbor bacterial growth, predisposing vulnerable patients to nosocomial respiratory infections. Local side effects include throat irritation, hoarseness, and oral fungal infections from inhaled steroids. Nurses must ensure emergency oxygen and suction equipment remain nearby when treating patients with severe reactive airway disease.
Effective home management depends on clear, reinforced patient education regarding device maintenance and symptom monitoring. Teach patients to wash plastic MDI holders and spacer devices weekly in warm soapy water and let them air dry without wiping. Instruct clients to keep a written log of daily peak flow readings to track lung function trends over time. Emphasize that rescue inhalers should never be overused as a substitute for prescribed daily anti-inflammatory controller medications. Remind patients to check expiration dates on canisters regularly and discard devices when the dose counter reaches zero.