A client in acute respiratory distress on a medical unit is receiving a nebulizer albuterol treatment. The client is annoyed because he already has an albuterol metered-dose inhaler (MDI)

Question

The nurse's response to the client's concern is based on the knowledge that:
1. Nebulized therapy is more cost-effective in the inpatient setting.
2. Suspension of the medication in liquid and delivery over a longer period increase the bronchodilator's effectiveness.
3. The nebulized form of the drug will have fewer negative effects on this distressed client.
4. The agitated and dyspneic client is unlikely to be able to use a metered-dose albuterol inhaler effectively.

Answer 1

Correct Answer: 2
Rationale 1: Nebulized treatments are more expensive because of additional equipment, supplies, and personnel.
Rationale 2: The client in acute distress benefits from the administration of a nebulizer treatment because the medication is delivered over a relatively longer period of time. Suspension in liquid particles with the use of a mouthpiece or mask and the assistance of a professional provider ensure that the medication will get to the lung's surfaces.
Rationale 3: The side effects might actually be more severe, particularly nervousness and increased heart rate.
Rationale 4: The client might have difficulty using an inhaler at this point, but that is not the primary rationale for using the nebulizer technique.
Global Rationale: These "breathing treatments" may take up to 30 minutes to administer the drug so it may not work as quickly as a drug taken from an MDI or DPI; however, medication delivered in this fashion is often more effective because it is delivered over many inhalations that occur during the period of medication delivery. Nebulizer treatments are typically more expensive, adverse effect profiles are not changed, and ease of use is not a factor determining intervention.