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Steam inhalation – Procedure, After care

PROCEDURE

Pre-procedure

  • Check the physician’s  order and nursing care plan
  • Explain the procedure to patient and ensure that patient has emptied his bowel and bladder It helps in promoting relaxation as Patient will have to remain in bed for 1 hour.
  • Auscultate the patient’s chest before and after the procedure.
  • Switch off the fans to prevent draught.
  • Keep the patient warm to prevent draught during before and after the procedure.
  • Effective steam inhalation should be at least for 15 to 20 minutes.

STEPS

Nelson’s inhaler

  1. Check the physician’s  order .
  2. Warm the inhaler by pouring a little hot water into the inhaler and emptying it after one minute. It reduces loss of heat from inhaler during procedure.
  3. Pour the required amount of inhalant into the inhaler and fill to a level below the spout with boiling water. The water  should remain just below the spout. If the inhaler is filled up to the level of spout there is possibility of drawing water into the mouth when inhaling and can cause scalds. If the spout is filled with water it will not act as an air inlet.
  4. Place sterile mouthpieces and close the inhaler tightly. See that the mouthpiece is in the opposite direction to the spout. This arrangement keeps the spout away from the patient when inhalation are taken in.
  5. Cover the mouth piece with a gauze piece and plug the spout with a cotton ball. Covering the mouthpiece with a gauze piece will prevent burns of the lips. Cotton ball in the spout will prevent escape of steam.
  6. Place a towel around the inhaler and position it in the bowl. It insulates the inhaler and prevents heat loss.
  7. Take it to the patient without losing time.
  8. Switch off fan/AC and close windows and doors
  9. Position the patient in high fowlers or sitting position.
  10. Place the apparatus conveniently in front of the patient on cardiac table with spout opposite to the patient. Remove the cotton plug and discard it into the kidney tray. Keeping the spout opposite to the patient reduces the chances of burns. Removing the cotton plug helps to open spout, so that it can act as an inlet for air.
  11. Instruct the patient to place lips on the mouthpiece and take deep breath. After removing the lips from the mouthpiece, breathe out air through nose. Directing the steam out through the nostril relieves the congestion of the mucous membranes of the nostril.
  12. Continue the treatment for 15 to 20 minutes as long as patient gets the steam. Observe the patient during procedure.
  13. Removes inhaler from the patient after the stated time, wipe off perspiration from the patient’s face
  14. Give chest physiotherapy and encourage patient to bring out sputum by coughing.
  15. Instruct the patient to remain in the bed for 1 to 2 hours.

Electric inhaler

  1. Explain the procedure to relieve anxiety and gain cooperation.
  2. Auscultate the patient lung fields to know the lung condition.
  3. Place him/ her in a sitting position for comfort.
  4. Put off the fan and cover the patient with a bed sheet or blanket to avoid chills or droughts to help collect the steam around the face of the patient to prevent steam loss.
  5. Place the electric inhaler to the cardiac table.
  6. Switch on the electric inhaler.
  7. Instruct the patient to inhale by mouth and exhale through the nose for 15 to 20 minutes – steam through nostrils relieves congestion of the mucous membranes.
  8. Keep the sputum cup with disinfectant ( 1% savlon) and face towel for spitting and wiping the face.
  9. Remove the inhaler, keep the patient in a comfortable position and observe him/ her frequently, keep him/ her well covered- to prevent chilling.

POST PROCEDURE

Documentation:- Record the treatment effectiveness and condition to evaluate before and after procedure.

After care

  1. Take articles to the utility room, empty the inhaler , clean the inside with alcohol to remove tr. Benzoin ( If used) .
  2. Wash it with warm soapy water and then rinse with clean water.
  3. Clean the ounce glass with alcohol swab followed by soapy water.
  4. Remove the gauze covering the mouthpieces and wash the mouthpieces with soap and water and send for autoclaving.
  5. Dry the articles and replace them. Wash hands.

References

  1. Nancy sr. (2008)Principles & practice of nursing. 6 th edition
  2. Jacob Annamma, R Rekha , Jadhav Sonali Tarachand.(2011) Clinical nursing procedures: the art of nursing practice.
  3. Perry, Potter. (2010)Fundamentals of nursing. 7th edition.

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