AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
Instructor
Serial/Semester
Location
Start/Finish Time
Date
LESSON OBJECTIVE
Performance: To gain an understanding of oxygen therapy.
Conditions:
The student will be presented a powerpoint presentation by the instructor and will have
all necessary references made available to him/her.
Standard:
1.
Given the five elements of the nursing care process and a patient requiring oxygen
therapy by correctly responding to written, oral, and experiential assessment
measures.
TEACHING POINTS
1. Define and list the signs and symptoms of
hypoxia, hypoxemia and cyanosis
2. Identify hazards and precautionary measures
when administering oxygen therapy.
3. Compare the cannula and mask equipment
available for oxygen therapy.
4. Develop a list of nursing considerations and
goals for the effective administration of
oxygen therapy.
5.
6.
7.
8
9.
10.
INSTRUCTIONAL STRATEGY
Interactive Lecture
Method:
Instructor
Media:
Classroom
Environment:
OTHER LESSON SPECIFICATIONS
Knowledge Lesson
Type of Lesson:
1/50
Ratio:
Resources:
.
End of Lesson Test: None
Instructional Time: 81
Reference(s):
ISBN 0-323-01727-4
Foundations of Nursing, 4th Edition
01 Jan 2003
Minutes
LESSON PLAN APPROVAL
Signature of Standards Officer
Date
AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
INTRODUCTION
Allocated Time:
Review:
5 Minutes
You have had previous anatomy and physiology lectures in your combat medic
training, this lecture will build upon prior instruction.
Objective:
To discuss/describe topics related to the nursing process.
Importance:
Nurses work in various health care settings so it is important to gain an
understanding of this subject as it will apply to your clinical practice.
Fit:
Oxygen therapy is the administration of oxygen as a medical intervention,
which can be for a variety of purposes in both chronic and acute patient care.
Oxygen is essential for cell metabolism, and in turn, tissue oxygenation is
essential for all normal physiological functions
Approach:
You will be presented the subject in lecture format and will be tested using a
written exam at a later date.
Control Statement:
If you have any questions during the lesson please feel free to ask.
BODY
1. Teaching Point: Define and list the signs and symptoms of hypoxia, hypoxemia and cyanosis
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Hypoxia
(1) Inadequate oxygen at the cellular level
(2) Signs and Symptoms
(a) Apprehension, anxiety, restlessness
(b) Decreased ability to concentrate
(c) Disorientation, decreased level of consciousness
(d) Increased fatigue, vertigo
(e) Behavioral changes
(f) Increased pulse rate; as hypoxia advances, bradycardia results
(g) Increased rate and depth of respiration; as hypoxia progresses, shallow,slow respirations develop
1
AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
(h) Elevated blood pressure; if O2 deficiency is not corrected, blood pressure will decrease
(i) Cardiac dysrhythmias
(j) Pallor, cyanosis, dyspnea
(k) Clubbing
b. Hypoxemia
(1) Reduced oxygen in the blood
(2) Signs and Symptoms
(a) Pallor, cyanosis, dyspnea
(b) Restlessness, anxiety
(c) Decreased level of consciousness
c. Cyanosis
(1) A blue discoloration to the skin, nail beds or mucous membranes caused by oxygen deficiency
(2) Signs and Symptoms
(a) Pallor due to bloodless coloration of skin
(b) Dark skinned individuals will have grayish cast to the skin
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Click here to enter the question.
Click here to enter the answer.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
2. Teaching Point: Identify hazards and precautionary measures when administering oxygen therapy.
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Fire
2
AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
(1) Smoking
(a) Advise patient not to smoke while receiving any form of oxygen therapy
(b) Avoid smoking areas and open flames
(c) Turn oxygen off when not in use
(d) Post sign OXYGEN IN USE
1) No lighters, matches or candles
2) Other items that can cause fires
a) Wool blankets
b) Nylon
(2) Electrical equipment
(a) Must be in good working order
(b) Proper ground using 3 pronged plug
(c) Encourage family members not to bring in the patient's own electric shaver from home.
(3) Oxygen must be kept away from combustible material
b. Drying of tissue
(1) Unless moisture is added tissue can become dry and crack increasing the risk of infection
(2) A humidifier (container of water) is usually attached between the flowmeter and the oxygen tubing
(3) As the oxygen passes (bubbles) through the water it is moisturized
(4) Other Nursing intervention
(a) Oral hygiene every 3-4 hours
(b) Inspect skin, nose, and mouth for signs of irritation
(c) Change delivery equipment regularly to reduce risk of infection
c. Oxygen toxicity
(1) Oxygen concentrations above 60% are rarely used because of the danger of oxygen toxicity
(a) In some patients, increased oxygen may affect their ventilatory drive mechanism
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AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
d. Monitor patient activity
(1) Activity increases oxygen demand
(2) Space activities to avoid exertion
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Click here to enter the question.
Click here to enter the answer.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
3. Teaching Point: Compare the cannula and mask equipment available for oxygen therapy.
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Oxygen Therapy
(1) Equipment
(a) Nasal Cannula - tube insertion into cavity
(b) Mask
1) Face mask
2) Non-rebreathing
3) Venturi Mask
(c) Face Tent
(d) Croupette
(2) Administration
(a) Cannula- nasal prongs inserted into the nares, given as liters per minute
1) Ordered by physician up to 6 liters per minute
2) Depends on blood gas report, condition of patient or pulse oximetry
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AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
3) Common rates fall between 4-6 liters per minute
4) Patients with obstructive pulmonary disease are given only 2-3 liters; higher rates reduce the
respiratory rate
5) Patient can move, talk and eat with cannula in place
6) Easy to dislodge, risk of necrosis
(b) Mask- available to administer concentrations ranging from 24% to 55% at 3-7L
1) Simple mask - low to medium concentrations with liter flow > 5 L/min; higher delivery of
oxygen than cannula. Obstructs the patients ability to eat, drink and oral medications. Causes pressure
necrosis by tight fit
2) Face mask with reservoirs- Partial rebreather- higher concentration 60-80%, must keep
reservoir bag inflated at all times . non-rebreather delivers 80-100%
3) Venturi- delivers consistent FIO2 regardless of breathing pattern; concentration listed on mask.
Useful when accuracy of delivery is essential;discomfort, not adaptive to oral meds and fluids; Causes
skin irritation
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Click here to enter the question.
Click here to enter the answer.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
4. Teaching Point: Develop a list of nursing considerations and goals for the effective administration of
oxygen therapy.
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. The goal for oxygen administration is to Improve or maintain systemic oxygenation. Oxygen therapy
is treated as a drug (medication) and it can have adverse affects.
(1) Increased oxygen saturation levels
(a) Blood gas
(b) Pluse oximetry
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AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
(2) Less fatigue
(3) Improved cognition
(4) Less irritation
b. Nursing goals
(1) Prevent complications
(a) Dry mucus membranes
(b) Infection
(c) Obstruction
(2) Patient education increases understanding of and compliance with treatment
(a) Reason for treatment
(b) Safety issues
(c) Activity restrictions
(d) Stop smoking
(e) Home care
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Click here to enter the question.
Click here to enter the answer.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
END OF LESSON TEST
Allocated Time:
Instructions:
Test Questions or
Performance
Expected:
Test Key:
0 Minutes
You will be tested on this subject at a later date.
You will be expected to review and study the material taught in this session in
order to pass the associated written test. If you have difficulty with the material
please see me so we can review together.
None.
CONCLUSION
Allocated Time:
6
5 Minutes
AFAMS Master Lesson Plan (MLP)
Nursing Program
Oxygen Therapy
Summary:
Review and re-emphasize the difficult Teaching Points below.
1.
2.
3.
4.
Define and list the signs and symptoms of hypoxia, hypoxemia and
cyanosis
Identify hazards and precautionary measures when administering
oxygen therapy.
Compare the cannula and mask equipment available for oxygen
therapy.
Develop a list of nursing considerations and goals for the effective
administration of oxygen therapy.
5.
6.
7.
8
9.
10.
Closing Statement:
Nurses work in various health care settings so it is important to gain an
understanding of this subject as it will apply to your clinical practice.
Re-motivating
Statement:
Oxygen therapy is the administration of oxygen as a medical intervention,
which can be for a variety of purposes in both chronic and acute patient care.
Oxygen is essential for cell metabolism, and in turn, tissue oxygenation is
essential for all normal physiological functions
7