Oxygen Therapy

Oxygen Therapy

Purpose
1. Heart & Lung Treatment (6)
2. Oxygenation (9)
  1. Cellular Respiration (9)
    1. ATP (Energy) Production (9)
      1. Cell Functioning (9)
        Organ Functioning (9)
        Homeostasis (9)
Documentation
Safety
1. Patient Complications/ Risks (8)
  1. Injury to Lining of Windpipe (8)
  2. Tube Slipping or Breaking (8)
  3. Pressure Sores (8)
  4. Infection (8)
  5. Supression of Drive to Breathe (8)
    1. Controlled by Oxygen Flow Rate (8)
  6. Dryness (8)
  7. Bloody Nose (8)
  8. Fatigue (8)
  9. Headaches (8)
  10. Skin Irritation (8)
  11. CO2 Retention (1)
  12. Substernal Pain (7)
  13. Pulmonary Oxygen Toxicity (7)
  14. Pulmonary Atelectasis (7)
  15. CO2 Narcosis (7)
2. Environmental
  1. Fire Hazard (6)
    1. Flammable Gas (6)
    2. No Open Flames/ Smoking (6)
    3. Do not Store in Confined Space (8)
3. Patient Monitoring (4)
  1. Mouth and Nose Care (7)
  2. Patency of Tubing (7)
    1. Oxygen Flow Rate (7)
Delivery Modes
1. Personal Care
  1. Pressure Area Care (7)
  2. Lubrication (6)
  3. Patient Positioning (7)
2. Devices
  1. Nasal Prongs (1)
    1. Inspiratory Oxygen Fraction (FI,O2) of 24-40% (1)
      1. 1-5 L/min (1)
  2. Face Masks
    1. Hudson (Simple) Mask (1)
      1. Delivers FI,O2 of 40-60% (1)
        5-10 L/min (1)
    2. Venturi Mask (1)
      1. Mixes Oxygen with Room Air (1)
      2. Delivers FI,O2 of 24, 28, 31, 35 and 40% (1)
    3. Non-Rebreathing Face Mask (1,4)
      1. Indicated when an FI,O2 >40% is required (1)
        8-10 L/min (1)
        Delivers FI,O2 up to 90% (1)
      2. Tightly sealed on face (1)
  3. Isolette (7)
    1. Neonatal (7)
  4. Transtracheal Tube (7)
    1. Humidification Requirements (7)
      1. Prevent Hypothermia (7)
      2. Prevent Dehydration (7)
Patient Assessment
1. Documentation (11)
  1. Patient Observation Chart/ Progress Notes (11)
2. Tests
  1. Chest X-Ray (7)
  2. Arterial Blood Gas (4)
    1. PaC02 (7)
      1. Normal = 35 - 45mm Hg (7)
    2. Haemoglobin
      1. Normal = 135-180 g/L (10)
    3. Pa02 (7)
      1. Normal = 80 - 100mm Hg (7)
    4. pH (7)
      1. Normal = 7.35 - 7.45 (7)
    5. To measure PaO2 and then used for the Titration of Oxygen Flow (2)
3. Neurological Assessment (7)
  1. Level of Consciousness (7)
4. Vital Signs
  1. Blood Pressure (10)
    1. Pulse (5)
      1. Respiratory Rate (5)
        Temperature (11)
        Normal = 36.5 - 37.2 Degrees Celsius (11)
        Normal = 12-20 Breaths/min (11)
      2. Normal = 60-100 Beats/min (11)
    2. Normal = Systolic <130 mmHg (11)
    3. Normal = Diastolic <85 mmHg (11)
  2. Sp02 (4)
    1. Oxygen Saturation to Haemoglobin (11)
    2. Normal = > 95% (7)
5. Age (7)
What is Oxygen Therapy?
1. How to Use
  1. Titrated to Lowest Oxygen Concentration Required to Meet Oxygenation Goals (4)
    1. Stable Patient (4)
      1. Discontinue Oxygen Therapy (4)
        Normoxia (4)
        Sp02 = > 95% (7)
        Breathing Room Air for 4 Hours (4)
        Cease Prescription (4)
    2. Reviewed Daily (7)
    3. Recommence if Sp02 < 95% (4)
  2. Clearance of Endogenous (4)
    1. Use of Suctioning Device (4)
  3. Prevent Excessive C02 Accumulation (4)
    1. Choice of Oxygen Device & Flow Rate (4)
      1. Depends on Patients Oxygen Requirements (7)
2. Medicine
  1. Oxygen Therapy Initiation
    1. Indications
      1. Hypoxaemia (4)
        Sp02 = < 90% (4)
      2. Respiratory Distress (5)
      3. Tissue Hypoxia (3,4)
        Shock (4)
      4. Sedation/ Decreased Level of Consciousness (7)
      5. Angina (5)
      6. Shortness of Breath (6)
      7. Respiratory Failure (3)
        PaO2 of <60 mmHg on Room Air (3)
      8. Failure to Oxygen-Haemoglobin Transport System (4)
        Anaemia (4)
        Carbon Monoxide Poisoning (4)
      9. Cyanosis (7)
      10. Palliative Care (7)
        Comfort Measures (7)
      11. Use of Accessory Muscles (7)
        Nostril Flaring (7)
        Intercostal and Sternal Recession (7)
        Tracheal Tug (7)
      12. Lethargy/ Restlessness (7)
      13. Chronic Obstructive Pulmonary Disease (COPD) (6)
    2. 1. Doctor (5)
      2. Legal Requirements (5)
        Signed (5)
        Dated (5)
        Completed (5)
        Medication Chart (7)
        Separate Oxygen Therapy Chart (7)
        Legiible (5)
        Written in Pen (5)
    3. Nurse Initiated (7)
      2. Medical Review Within 30mins (7)
        Prescription (5)
    4. Reduces Energy Requirements (4)
3. Benefits (6)
  1. Increases Low Blood Oxygen/ Oxygen Supply (6)
  2. Reduces Work of Breathing (4)
  3. Improves Medical Outcomes (6)

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