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Oxygen-Therapy (1)

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Oxygen
Therapy
Oxygen Therapy
• Oxygen Therapy is the administration
of oxygen to the client by any route to
prevent or relieve hypoxia.
The provision of oxygen to the client with higher
concentration than that found in air.
Rationale:
Oxygen is essential to life. An optimum level of
oxygen must be maintained to sustain mental
functioning.
Indication
• Any condition which either actually or
potentially lead to hypoxia or hypoxemia.
Examples: chronic obstruction, respiratory
depression,inflammation and cardiac
insufficiency.
Methods of Oxygen Delivery:
a. Nasal Cannula/ Prongs- simple,
comfortable, low flow (24%-45%) device
inserted into the nostrils to deliver at a rate up
to 5-6 liters/min.
It consist of a rubber or plastic tubings that
extends around the face with ¼ to ½ inch
curved prongs that fit into the nostrils.
Purposes:
1. To deliver a relatively low concentration of
oxygen when only minimal support is
required.
• 2. To allow uninterrupted delivery of oxygen
while the client ingest foods and fluids.
• To permit some freedom and movement and
comfort to client.
FACE MASK
• A device that covers the clients nose and
mouth for oxygen inhalation. They are made
of clear pliable plastic or rubber that can be
molded to fit the face. Held to the clients
head with elastic
Preparation:
Assemble Equipments and Supplies
Cannula
Face Mask
Face Tent
• Determine
• The order for oxygen
• Levels of oxygen
• V/S
• Diagnostic results
ASSESSMENT
• 1. Identified patient using two identifiers.
• 2. Reviewed patient chart or heath record
including health care provider's order and
nurses notes.
• 3. Reviewed patient order for oxygen, noting
delivery method, flow rate, duration of oxygen
therapy, and parameters for titration of oxygen
settings.
• 4 Assessed patients/ family caregiver's health
literacy.
• 5.Perform hand hygiene and apply clean
gloves.
• 6. Performed respiratory assessment.
• 7. Observed for cognitive and behavioral
changes.
• 8. Assessed airway patency and remove airway
secretions by having patient cough and expectorate
mucus or by suctioning. Auscultated lung sounds.
Removed and disposed of gloves and performed hand
hygiene if there was contact with mucus. Then
reapplied gloves if further contact with mucus was
likely.
• 9. Inspected condition of skin around nose and ears.
• 10. Removed and discarded gloves if worn; performed
hand hygiene.
• 11. Assessed knowledge and experience of patient
and family caregiver with oxygen administration.
• 12. Assessed patient's goals or preferences
for how oxygen administration should be
performed.
• PLANNING
• 1. Determined expected outcomes following
completion of procedure.
• 2. Gathered equipment/supplies at patient's
bedside.
• 3. Closed room door or curtains around
bed.
• 4.
Instructed patient and/or family
caregiver about need for oxygen. If the
oxygen was for home use, educated
patient about oxygen safety in the home
and the equipment that would be used
IMPLEMENTATION
• IMPLEMENTATION
• 1. Performed hand hygiene. Applied PPE.
• 2. Adjusted bed to appropriate height and
lowered side rail on side nearest you.
Positioned patient comfortably in semi-Fowler
position.
• 3. Attached oxygen-delivery device to oxygen tubing
and attached end of tubing to humidified oxygen
source (if needed) adjusted to prescribed flow rate:
a. Placed tips of the nasal cannula into patient's nares.
If tips were curved, they should have pointed downward
inside nostrils. Then looped cannula tubing up and over
patient's ears. Adjusted lanyard so cannula fit snugly
but not too tightly without pressure to patient nares and
ears.
b. Applied any type of oxygen mask by placing it over
patient's mouth and nose. Then brought straps over
patient's head and adjusted to form a comfortable but
tight seal.
• 5. Maintained sufficient slack on oxygen
tubing.
• 6. Observed for proper function of oxygendelivery de-vice:
• a. Nasal cannula: Cannula was positioned
properly in nares; oxygen flowed through tips.
• b. Oxygen-conserving cannula: Fitted as for
nasal cannula. Reservoir was located under
patient's nose or worn as a pendant.
• c. Nonrebreather mask: Applied as regular
mask.
• Contained one-way valves with reservoir;
exhaled air did not enter reservoir bag.
• d. Simple face mask: Selected appropriate
flow rate.
• e. Venturi mask: Selected appropriate flow
rate.
• f. High-flow nasal cannula: Fitted as for nasal
cannula.
• 7. Verified setting on flowmeter and oxygen source for
proper setup and prescribed flow rate.
• 8. Checked cannula/mask and humidity device if used)
every 8 hours or as agency policy indicated.
• Ensured that humidity container was filled at all
times.
• 9. Posted "Oxygen in use" signs on wall behind bed
and at entrance to room (per agency policy).
• 10. Helped patient to comfortable position. Raised
side rails (as appropriate) and lowered bed to lowest
position.
• 11. Place nurse call system in an accessible
location within patients reach.
• 12. Properly disposed of gloves and other PPE,
of used, and performed hand hygiene.
EVALUATION
• EVALUATION
• 1. Monitor patients response changes in oxygen
flowrate with SpO. Note: Monitored ABCs when
ordered.
• 2. Performed respiratory assessment. Obtained vital
signs
• 3. Assessed adequacy of oxygen flow each shift or per
agency policy.
• 4. Observed pase mucous memoran, bridge of nose,
nares, and nasal mucous membranes for evidence of
skin breakdown.
• 5. Used Teach-Back. Revised instruction if patient or
family caregiver was not able to teach back correctly.
• RECORDING
• 1. Recorded the respiratory assessment findings,
method of oxygen delivery, oxygen flow rate, patient's
response to intervention, and any adverse reactions
or side effects; recorded status of patient's skin
integrity on flow sheet in nurses' notes in EHR or
chart.
• 2. Documented evaluation of patient and family caregiver
learning.
• HAND-OFF REPORTING
• 1. Reported patient status, including recent assessment
findings, vital signs, SpO2, and skin integrity before and
after oxygen administration.
• 2. Reported the type of oxygen-delivery device initiated and
used, the initial flow rates, and whether any adjustments to
the flow rate were made during the Shift. Included the
patient response to the flow rate adjustments and what
interventions were successful.
• 3. Reported any unexpected outcome to health care
provider or nurse in charge.
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