For the patient to breathe easily, his air Passages must be kept clear. This may be a straightforward matter of making sure he changes position frequently, or it may require some active care. The patient may nave a cough that needs to be controlled, or the asthmatic may need his spasm relieving. You may also have to help the patient to clear a blocked nose. In every case, you should assess his general condition and decide on the amount of help he needs to breathe normally.
Clearing a blocked nose
If the patient’s upper respiratory passages e blocked or irritated, they may be soothed and moistened with the help of steam inhalations. These are made by mixing a drug with almost boiling water (boiling water may vaporize irritant substances as well as the soothing ones), and allowing the patient to inhale the vapour.
Several different drugs may be mixed with the water depending on the patient’s needs: friars’ balsam is soothing and reduces inflammation in the trachea (tracheitis) and in the bronchi (bronchitis). Menthol, eucalyptus and pine help to clear the air passages by shrinking the mucus membrane lining the nose and the sinuses. Which drug you use, and in what quantity, will depend on the instructions given to you by the doctor or community nursing sister. In the absence of instructions, however, the usual dose is 5ml of friars’ balsam to 600ml of water, or 1-2 crystals of menthol to 600ml of water.
To give a steam inhalation, you will need:
- a tray
- a large one-litre jug
- a cover for the jug
- a bowl in which to stand the jug
- water just off the boil
- the appropriate drug and a measure
- a large towel
- a sputum cup or plastic yoghurt pot
- paper handkerchiefs
With the patient sitting upright in bed, place a bed-table or bed-tray in front of him or pull a locker or table as close to the side of the bed as you can. If the patient is in a chair, place a small table in front of him. If his nose if very sore, smear the area with petroleum jelly before starting treatment.
Pour half the water into the jug and add the drug. Add the remaining water, but do not fill the jug more than two-thirds full. Wrap the cover around the jug and place both in the bowl on the tray, with the sputum cup and paper handkerchiefs. p|ace in front of the patient. Help him to arrange the towel over the jug and the mouth and nose. The patient should then breathe in through his mouth and out through his nose while the steam rises (this will be for about 10 to 15 minutes). He can place the towel over his head and the inhaler like a tent; women patients, however, usually prefer to arrange the towel so that it just covers the face, as it is less likely to make their hair limp.
After the treatment, clear away and leave the patient comfortable. If he is up and about, suggest that he remains in the warm for the next half hour.
Other methods of clearing the nose can be used: sprays can be squirted into the nose or nasal drops can be given. Always follow the instructions on the labels with care. Do not use for more than seven days without seeing your doctor.
