# Nebulisation Nursing

> Nebulisation nursing procedure for BSc and GNM — technique, drug preparation, flow rate, patient teaching and side effects explained simply.

- Canonical URL: https://prepelephant.com/topics/allied/nursing/nebulisation-nursing
- Exam / course: Allied Health · Subject: Nursing
- Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team
- First published: 2026-10-02
- Last updated: 2026-10-02
- How to cite: "Nebulisation Nursing", PrepElephant, https://prepelephant.com/topics/allied/nursing/nebulisation-nursing

## Direct answer
Nebulisation is the administration of medication as a fine aerosol mist inhaled through a mouthpiece or mask, delivering bronchodilators, corticosteroids or mucolytics directly to the airways in asthma, COPD and other obstructive lung diseases. The nurse dilutes the ordered drug with normal saline to about 4-5 ml, runs the nebuliser at the recommended flow (commonly 6-8 litres per minute for adults) until the mist stops in roughly 10 minutes, and observes the patient throughout. Mouth rinsing after inhaled steroids, cleaning of the device, and watching for tremor and tachycardia complete safe practice.

## What you must remember
- Commonly nebulised drugs: short-acting beta-2 agonists (salbutamol), anticholinergics (ipratropium), inhaled corticosteroids (budesonide) and mucolytics; combination doses are prepared exactly as ordered.
- Fill the nebuliser cup with the drug plus normal saline diluent to about 4-5 ml; a treatment usually lasts close to 10 minutes until misting stops.
- Driving gas flow is commonly 6-8 litres per minute for adults; use compressed air, not oxygen, in patients at risk of carbon dioxide retention.
- Sit the patient upright, encourage slow deep breaths with a brief pause at end-inspiration, and prefer a mouthpiece in adults to reduce facial and eye deposition.
- After inhaled corticosteroids the patient must rinse and spit — this prevents oral candidiasis (thrush) and hoarseness.
- Side effects to monitor: tremor, tachycardia, palpitations, headache and, with frequent high-dose beta agonists, hypokalaemia; assess breath sounds and peak flow before and after.
- Clean and air-dry the mask, mouthpiece and cup after each use; do not share devices between patients, and replace them per the manufacturer's schedule.

## Common confusion
Nebulisation is often equated with oxygen therapy. The nebuliser simply converts liquid drug into aerosol — the driving gas may be oxygen or compressed air, and the procedure is judged by bronchodilator response, not by saturation alone. The second classic error is letting a steroid nebulisation finish without mouth care, which is exactly how oral thrush appears in exam scenarios.

## Exam-focused takeaway
Procedure-based questions dominate: steps in order, diluent and volume, flow rate, duration, and the crucial instruction to rinse the mouth after steroids. MCQs test side effects of salbutamol, choice of driving gas in COPD with CO2 retention, and single-patient use of nebuliser sets. Viva examiners frequently ask how you would teach a caregiver at home to use a compressor nebuliser for a child.

## Frequently asked questions

### How is a nebulisation performed step by step?
Hand hygiene, verify the prescription, place the drug diluted in normal saline in the cup, connect the gas source at the ordered flow, and let the patient inhale until misting ceases. Then encourage coughing, rinse the mouth if a steroid was given, clean the equipment and document.

### Why is normal saline added to the drug?
Saline dilutes the drug to a volume of about 4-5 ml that nebulises efficiently over close to 10 minutes. Too small a volume leaves drug in the cup and underdoses the patient.

### Why must the mouth be rinsed after steroid nebulisation?
Residual drug in the mouth and pharynx can cause oral candidiasis and hoarseness. Rinsing and spitting after each steroid treatment removes the deposit.

### What side effects should the nurse watch for?
Fine hand tremor, tachycardia, palpitations, headache and, with repeated high doses, falling serum potassium. Severe tachycardia or worsening breathlessness is reported immediately.

### When should compressed air be preferred over oxygen to drive the nebuliser?
In COPD patients with carbon dioxide retention, high-flow oxygen can worsen hypercapnia. Compressed air drives the nebuliser while oxygen is titrated separately.