Study Effectiveness Of Nebulization Improving Childrens Respiratory Status Nursing Essay

Study Effectiveness Of Nebulization Improving Childrens respiratory Status Nursing look forData analysis is the systematic organization and synthesis of research data and testing of research assumption using those data. Interpretation is the process of making sense of the result and examining their implication (Polit, 2004). Analysis is the method of interpretation qualitative data cerebrateingful and providing intelligible information, so that the research problem can be examine and tested, including the relationship in the midst of the variables.The study was conducted among children with wheezy to compare the effectiveness of nebulization with type O and without atomic number 8 in upward(a) their respiratory status. The data was collected, assembled, analyzed and tested and the findings based on the analysis are presented in this chapter.4.1 demographic Variables of Children with asthmatic The epoch of the children with reedy ranged surrounded by one month to five hi storic full point. Out of this, 8 (16%) children were mingled with the age group of one month to one year, 17 (34%) were between 1-3 years and 25 (50%) were between the age group of 3-5 years. Majority of the children were males (62%) and female children were 38%. 34 (68%) children belonged to nuclear family whereas 16 (32%) children belonged to joint family. LPG was utilise as the cooking fuel in all (100%) the houses (Table 4.1).4.2 Family History of Smoking Habits In nebulization with type O group, 5(20%) children had the family annals of smoking habit. For majority (4) of children, grandfather was the person who smokes and for one child father was the smoking person. In nebulization without atomic number 8 group, fathers of 3(12%) children smoke in the family (Table 4.2).4.3 Family History of Respiratory Diseases 5 (20%) children in the nebulization with type O group had a family tale of bronchial asthma, out of which one person is on regular treatment. In nebulization w ithout oxygen group, 5(20%) children had a family history of asthma and 3(12%) had a family history of COPD, out of which one person is on regular treatment (Table4.3).4.4 History of Respiratory Diseases in Children With regard to previous history of respiratory ailments, majority (64%) of children had wheeze associated lower respiratory transmission (WALRI) in nebulization with oxygen group whereas in nebulization without oxygen group, 15 (60%) children had WALRI, .6 (24%) children had hyper reactive airway disease (HRAD) and 3 (12%) children had asthma in nebulization with oxygen group , whereas in nebulization without oxygen group,7 (28%) children had asthma and 3 (12%) had HRAD (Table.4.4).About the attempt of respiratory diseases, 14 (56%) children developed respiratory diseases onwards 1year of age and 5 (20%) children developed between the age group of 1-2 years in nebulization with oxygen group whereas in nebulization without oxygen group, 10 (40%) children developed bef ore 1year of age and 7 (28%) children developed between 1-2 years of age (Table.4.4).Regarding the duration of the disease, 14 (56%) children had the duration of disease less than a year and 6 (24%) had the duration between1-2 years in nebulization with oxygen group whereas in nebulization without oxygen group, 11 (44%) children had duration of less than 1 year and 8 (32%) had the duration between 1-2 years (Table.4.4).With regard to the regularity of the treatment, 3(12%) children in the nebulization with oxygen group and 6 (24%) children in the nebulization without oxygen group were on regular treatment. All these children were using inhalers. Majority of the children (66.66%) were using a combination of salbutamol -fluticosone inhaler in two groups and the rest (33.33%) were using asthalin alone (Table.4.4).4.5 Immunization History All the children (100%) in both groups were completely immunized.4.6 Pre appraisal of Respiratory Parameters in Nebulization with atomic number 8 c onvocation The initial legal opinion of respiratory regulate of children in nebulization with oxygen group showed that 6 (24%) children were in mild put out, 6 (24%) children were in hold in distress and 13 (52%) children were in tough distress. In the opinion of oxygen color, 20 (80%) children had mild de intensity (95-97% in way air) and 5 (20%) children had verify de impregnation (90-94%in room air).In the initial appraisal of wheezing, 12 (48%) children were having wheezing on terminal expiration and 13 (52%) children were having wheezing on entire expiration.The appraisal of retraction showed that 16 (64%) children were recipe, 8(32%) children had intercostal retractions and 1 (4%) child had intercostal and substernal retractions..In the initial dyspnea judgement, 5 (20%) children were having mild dyspnea and 20 (80%) children were frequent (Table 4.5).4.7 Pre assessment of Respiratory Parameters in Nebulization without Oxygen aggroup The initial respiratory rate assessment of children in nebulization without oxygen group showed that 10 (40%) children were in mild distress, 8 (32%) children were in mollify distress and 7 (28%) children were in severe distress. In the assessment of oxygen saturation, 22 (88%) children had mild desaturation (95-97% in room air) and 3 (12%) children had check into desaturation (90-94%in room air). In the initial assessment of wheezing, 17 (68%) children were having wheezing on terminal expiration and 8 (32%) children were having wheezing on entire expiration. Initial retraction assessment showed that 18 (72%) children had intercostal retractions and 7 (28%) children had intercostal and substernal retractions. In the assessment of dyspnoea, 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.6).4.8 Implementation of Therapies among Children with Wheezing4.8.1 Administration of nebulization with oxygen Nebulization with oxygen was provided to 25 children with wheezing who were prescribed for Combimist nebulization in the OPD. Nebulization was provided by the staff nurse for a period of 15-20 transactions. Children who were on treatment prior to the nebulization were not included in the study. estimate was make before and by and by nebulization with oxygen.4.8.2 Administration of nebulization without oxygen Nebulization without oxygen was provided by the staff nurse to 25 children with wheezing who were prescribed with Combimist (Salbutamol+ Ipravent) nebulization in the OPD. Nebulization was provided for a period of 15-20 proceedings. Children who were on treatment prior to the nebulization were not included in the study. Assessment was done before and after nebulization with oxygen.4.9 mooring assessment of Respiratory Parameters in Nebulization with Oxygen Group4.9.1 Post Assessment at 5 transactions In the send off 5 transactions assessment of respiratory rate of children in nebulization with oxygen group,1 (4%) child reached normal ,7 (28%) c hildren were in mild distress,5 (20%) children were in apply distress and 12 (48%) were in severe distress. In the assessment of oxygen saturation, 4 (16%) children reached normal saturation, 17 (68%) children had mild desaturation (95-97% in room air) and 4 (16%) children had moderate desaturation (90-94%in room air). breathe assessment showed that 1 (4%) child became normal, 13 (52%) children were having wheezing on terminal expiration and 11 (44%) children were having wheezing on entire expiration. In the assessment of retraction, 16 (64%) children were normal, 8 (32%) children had intercostal retractions and 1 (4%) child had intercostal and substernal retractions.In the dyspnoea assessment, 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.5).4.9.2 Post Assessment at 10 transactions In the post 10 proceedings assessment of respiratory rate of children,1 (4%) child reached normal ,8 (32%) children were in mild distress,7 (28%) children we re in moderate distress and 9 (36%) were in severe distress. Assessment of oxygen saturation revealed that 13 (52%) children were having normal saturation, 11 (44%) children had mild desaturation (95-97% in room air) and 1 (4%) child had moderate desaturation (90-94%in room air). In the assessment of wheezing, 10 (40%) children were relieved from wheezing, 11 (44%) children were having wheezing on terminal expiration and 4 (16%) children were having wheezing on entire expiration. Assessment of retractions showed that 21 (84%) children became normal, 4 (16%) children had intercostal retractions.In the dyspnoea assessment, 22 (88%) children were having no dyspnoea and 3 (12%) children were having mild dyspnoea (Table 4.5).4.9.3 Post Assessment at 15 minutes Post 15 imports assessment of respiratory rate showed that 5 (20%) child reached normal ,5 (20%) children were in mild distress,9 (36%) children were in moderate distress and 6 (24%) were in severe distress. In the assessment of oxygen saturation, 17 (68%) children reached normal saturation, 8 (32%) children had mild desaturation (95-97% in room air). In the assessment of wheezing, 12 (48%) children were relieved from wheezing, 12 (48%) children were having wheezing on terminal expiration and 1(4%) child was having wheezing on entire expiration. The assessment of retractions revealed that 23 (92%) children became normal, 2 (8%) children had intercostal retractions.Dyspnoea assessment showed that 23 (92%) children became normal and 2 (8%) children were having mild dyspnoea (Table 4.5).4.9.4 Post Assessment at 30 Minutes Post 30 assessment of respiratory rate showed that 11 (44%) child reached normal, 7 (28%) children were in mild distress, and 4 (16%) children were in moderate distress and 3 (12%) were in severe distress. In the assessment of oxygen saturation, 19 (76%) children reached normal saturation, 5 (20%) children had mild desaturation (95-97% in room air) and 1 (4%) child had moderate desaturation. In the assessment of wheezing, 14 (56%) children were relieved from wheezing, 11 (44%) children were having wheezing on terminal expiration. The assessment of retractions showed that 24 (96%) children became normal, 1 (4%) children had intercostal retractions. Dyspnoea assessment revealed that 23 (92%) children reached normal and 2 (8%) children were having mild dyspnoea (Table 4.5).4.10 Post assessment of Respiratory Parameters in Nebulization without Oxygen Group4.10.1 Post Assessment at 5 Minutes Post assessment of respiratory rate showed that 11 (44%) children were in mild distress, 8 (32%) children were in moderate distress and 6 (24%) were in severe distress. In the assessment of oxygen saturation, 1 (4%) child reached normal, 21 (84%) children had mild desaturation (95-97% in room air) and 3 (12%) children had moderate desaturation (90-94%in room air).Assessment of wheezing showed that 2 (8%) children became normal, 15 (60%) children were having wheezing on terminal expiratio n and 8 (32%) children were having wheezing on entire expiration. In the assessment of retraction, 19 (76%) children had intercostal retractions and 6 (24%) children had intercostal and substernal retractions. Dyspnoea assessment showed that 5 (20%) children were having mild dyspnoea and 20 (80%) children were normal (Table 4.6).4.10.2 Post Assessment at 10 Minutes Post 10 minutes assessment of respiratory rate revealed that 4 (16%) children reached normal rate, 10 (40%) children were in mild distress,7 (28%) children were in moderate distress and 4 (16%) were in severe distress. In the assessment of oxygen saturation, 7 (28%) children reached normal, 15 (60%) children had mild desaturation (95-97% in room air) and 3 (12%) children had moderate desaturation (90-94%in room air). Assessment of wheezing showed that 16 (64%) children became normal, 4 (16%) children were having wheezing on terminal expiration and 5 (20%) children were having wheezing on entire expiration. In the assessme nt of retraction, 22 (88%) children became normal and 3 (12%) children had intercostal retractions. Dyspnoea assessment revealed that, 3 (12%) children were having mild dyspnoea and 22 (88%) children became normal (Table 4.6).4.10.3 Post Assessment at 15 Minutes In the post assessment of respiratory rate,9 (36%) children reached to normal rate, 7 (28%) children were in mild distress, 5 (20%) children were in moderate distress and 4 (16%) were in severe distress. The post assessment of oxygen saturation showed that 10 (40%) children reached normal, 13 (52%) children had mild desaturation (95-97% in room air) and 2 (8%) children had moderate desaturation (90-94%in room air). Wheeze assessment at 15 minutes showed that 19 (76%) children became normal, 6 (24%) children were having wheezing on terminal expiration. In the assessment of retraction, 24 (96%) children became normal, 1 (4%) children had intercostal retractions. Evaluation of dyspnoea revealed that 2 (8%) children were having mild dyspnoea and 23 (92%) children were normal (Table 4.6).4.10.4 Post Assessment at 30 Minutes Post assessment of respiratory rate showed that 13 (52%) children reached normal rate, 7 (28%) children were in mild distress, 2 (8%) children were in moderate distress and 3 (12%) were in severe distress. In the assessment of oxygen saturation, 10 (40%) child reached normal, 13 (52%) children had mild desaturation (95-97% in room air) and 2 (8%) children had moderate desaturation (90-94%in room air). In the assessment of wheezing, 19 (76%) children became normal, 6 (24%) children were having wheezing on terminal expiration. Assessment of retraction revealed that 24 (96%) children had no retractions, 1 (4%) children had intercostal retractions.Dyspnoea assessment showed that1 (4%) child was having mild dyspnoea and 24 (96%) children became normal (Table 4.6).4.11 Comparison of convey Difference of Pre and Post Assessment of Respiratory Parameters in Nebulization with Oxygen Group and Ne bulization without Oxygen Group4.11.1 call up Difference of Respiratory Rate in Nebulization with Oxygen Group and Nebulization without Oxygen Group In nebulization with oxygen group, the pre toy with think ofs of respiratory rate was 41.68 and post hatch observe at 5 minutes was 40.4.Post mean judges at 10 minutes was 37.76, at 15 minutes was 35.6 and at 30 minutes was 32.8. The mean residuum between pre and post respiratory rate at 30 minutes was 8.88. This shows a significant reduction in respiratory rate after nebulization with oxygen.The pre mean honour of respiratory rate in nebulization without oxygen group was 36.64 .The post mean value of respiratory rate at 5 minute was 36, at 10 minutes was 34.32, at 15 minutes was 32.48 and at 30 minutes was 30.96. The mean diversion between pre and post respiratory rate at 30 minutes was 5.68. This shows a reduction in respiratory rate after nebulization without oxygen. Therefore, it can be inferred that the mean difference was high in nebulization with oxygen group comparing to nebulization without oxygen group. This showed that nebulization with oxygen is effective in decrease tachypnea among children with wheezing (Table 4.7).4.11.2 Mean Difference of Oxygen Saturation in Nebulization with Oxygen Group and Nebulization without Oxygen Group Oxygen saturation above 98% in room air is considered as the normal saturation level. The pre mean value of oxygen saturation in nebulization with oxygen group was 95.24. The post mean value of oxygen saturation at 5 minute was 96, at 10 minutes was 97.24, at 15 minutes was 98.08 and at 30 minutes was 98.32. The mean difference between pre and post oxygen saturation at 30 minutes was 3.08. This shows an improvement in oxygen saturation after nebulization with oxygen.The pre mean value of oxygen saturation in nebulization without oxygen group was 95.72 .The post mean value of oxygen saturation at 5 minute was 95.88, at 10 minutes was 96.68 at, 15 minutes was 97.36 a nd at 30 minutes was 97.08. The mean difference between pre and post respiratory rate at 30 minutes was 1.36. Therefore, it can be inferred that the mean difference was high in nebulization with oxygen group comparing to nebulization without oxygen group. This showed that nebulization with oxygen is effective in improving the oxygen saturation among children with wheezing (Table 4.7).4.11.3 Mean Difference of Wheeze Score in Nebulization with Oxygen Group and Nebulization without Oxygen Group Auscultation of normal vesicular breath sounds is considered as normal. The pre mean value of wheeze pass water in nebulization with oxygen group was 1.52. The post mean value of wheeze fit at 5 minute was 1.4, at 10 minutes was 0.72, at 15 minutes was 0.56 and at 30 minutes was 0.44. The mean difference between pre and post wheeze grade at 30 minutes was1.08. This showed an improvement in wheeze fit after nebulization with oxygen.The pre mean value of wheeze score in nebulization without o xygen group was 1.32. The post mean value of wheeze score at 5 minute was 1.12, at 10 minutes was 0.56, at 15 minutes was 0.24 and at 30 minutes was 0.24. The mean difference between pre and post wheeze score at 30 minutes was 1.08. This showed that there was no mean difference in wheeze score in nebulization with oxygen group and nebulization without oxygen group. Hence, nebulization with oxygen and nebulization without oxygen has similar effect in reducing wheeze score among children with wheezing (Table 4.7).4.11.4 Mean Difference of Retraction Score in Nebulization with Oxygen Group and Nebulization without Oxygen Group Observation of normal chest movements is considered as normal. In nebulization with oxygen group, the pre mean value of retraction score was 0.4. The post mean value of retraction score at 5 minute were 0.4, at 10 minutes was 0.16, at 15 minutes was 0.08 and at 30 minutes was 0.04. The mean difference between pre and post wheeze score at 30 minutes was 0.36. This showed an improvement retraction score in nebulization with oxygen group.The pre mean value of retraction score in nebulization without oxygen group was 0.28. The post mean value of retraction score at 5 minute was 024, at 10 minutes was 0.12, at 15 minutes was 0.04 and at 30 minutes was 0.04. The mean difference between pre and post retraction score at 30 minutes was 0.24. This showed that there was no mean difference in retraction score in nebulization with oxygen group and nebulization without oxygen group. Hence, nebulization with oxygen and nebulization without oxygen has similar effect in reducing retraction score among children with wheezing (Table 4.7).4.11.5 Mean Difference of Dyspnoea Grade in Nebulization with Oxygen Group and Nebulization without Oxygen Group Grade 0 is regarded as absence of dyspnoea. In nebulization with oxygen group, the pre mean value of dyspnoea grade was 0.2. The post mean values of dyspnoea grade at 5 minute were 0.2, at 10 minutes was 0.12, at 1 5 minutes was 0.08 and at 30 minutes was 0.08. The mean difference between pre and post dyspnoea grade at 30 minutes was 0.12. This showed an improvement in dyspnoea grade in nebulization with oxygen group.The pre mean value of dyspnoea grade in nebulization without oxygen group was 0.2. The post mean values of dyspnoea grade at 5 minute was 0.2, at 10 minutes was 0.12 ,at 15 minutes was 0..08 and at 30 minutes was 0..04. The mean difference between pre and post dyspnoea grade at 30 minutes was 0.16. Hence the result highlighted that the mean difference was slightly higher in nebulization without oxygen comparing to nebulization with oxygen. This showed that nebulization with oxygen had similar effect in reducing dyspnoea grade among children with wheezing (Table 4.7).4.12. Effectiveness of Nebulization with Oxygen in Improving the Respiratory Parameters among Children with Wheezing through Pairedt test Analysis Paired t test was used to assess the differences in pre and post assess ments of respiratory parameters among nebulization with oxygen group. (Table 4.8).4.12.1 Comparison of Pre and Post 5 Minutes, 10 Minutes, 15 Minutes and 30 Minutes Assessment of Respiratory Rate in Nebulization with Oxygen Group Hypothesis There will be a significant difference in pre and post assessment of respiratory rate in nebulization with oxygen group.t =t5min ==2.67t10min ==5t15min ==7.89t30min==12.94The calculated values of t at 5,10,15 and 30 minutes are 2.67, 5, 7.89 and 12.94 on an individual basis which are greater than the tabulated value at p