| Knowledge |
|
States Contraindications and Relative Contraindications of procedure.
|
|
|
| Preparation |
| Clinical Standards for Procedures and Interventions. |
|
|
| Verifies the indication, medication, concentration, dose, patient weight when applicable, duration, allergies, and continuous-nebulization order or protocol. |
|
|
| Assessment |
| Determines exacerbation severity using respiratory rate, heart rate, blood pressure, oxygen saturation, mental status, speech, work of breathing, air entry, wheeze or silent chest, and peak expiratory flow or FEV1 when feasible. |
|
|
| Preparation |
| Independently calculates and verifies the total medication dose, concentration, diluent volume, delivery rate, and expected treatment duration; labels the reservoir or syringe. |
|
|
| Selects a continuous jet or approved vibrating-mesh delivery system, appropriate interface, driving gas or controller, oxygen source, monitoring equipment, and backup bronchodilator-delivery method. |
|
|
| Implementation |
| Assembles the system according to the validated device configuration, confirms continuous aerosol output without leaks or obstruction, and initiates the prescribed dose and oxygen support. |
|
|
| Monitoring & Modifications |
| Continuously monitors respiratory status, oxygen saturation, heart rate and rhythm, work of breathing, mental status, air entry, and tolerance; obtains blood pressure at appropriate intervals. |
|
|
| Reassesses symptoms, auscultation, peak expiratory flow or FEV1 when feasible, oxygen requirement, and overall trajectory at protocol-defined intervals. |
|
|
| Checks the medication reservoir, tubing, aerosol generator, driving flow or controller, interface seal, and condensate frequently to prevent interrupted or inaccurate delivery. |
|
|
| Monitors for tremor, agitation, tachycardia, arrhythmia, chest discomfort, and paradoxical bronchospasm; evaluates potassium, glucose, and lactate when prolonged high-dose therapy or the clinical condition warrants. |
|
|
| Immediately escalates for a silent chest, exhaustion, altered mental status, worsening hypoxemia or hypercapnia, hemodynamic instability, severe arrhythmia, or failure to improve. |
|
|
| Post-Intervention |
| Transitions, tapers, or discontinues continuous therapy only according to the response-based protocol or authorized order and ensures the next bronchodilator plan is available. |
|
|
| Documents total drug dose, concentration, device, duration, oxygen support, serial assessments, objective airflow measures, adverse effects, and escalation or transition decisions. |
|
|
| Post-Intervention Management Steps. |
|
|
