Oxygenation therapy. refer to manual for administration guidelines, etc.

2. Concentration is expressed as a percentage, or as a fraction of inspired oxygen.

3. The concentration is of more importance than the liter flow per minute

4. As a general rule for safe oxygen therapy is to use the lowest oxygen concentration or flow possible to achieve an acceptable blood oxygen

5. High oxygen concentrations are toxic to lung tissue

7. Safety precautions are essential during oxygen therapy. Although oxygen by itself will not burn or explode, it does facilitate combustion.

8. A “no smoking sign must be posted on the client’s room

9. Make sure that electrical devices are in good working order to prevent recurrence of short circuit sparks

10. Safety Alert: Avoid materials that generate static electricity such as woolen blankets and synthetic fabrics. Cotton blanket should be used

11. Avoid the use of volatile, flammable materials near clients receiving oxygen such as oil, greases, alcohol, and acetone.

12. Be sure that electric monitoring equipment, suction machines and portable diagnostic machines are electrically grounded

13. Make know the location of the fire extinguishers

14. Suppression of ventilation or hypoventilation- as the PaO2 (pressure of oxygen in the arterial blood) increases with supplemental oxygen, the stimulus for respiration may be blunted or eliminated. This results to hypoventilation and respiratory arrest. S/SX includes decrease rate and depth of respiration and a decreasing level of consciousness

15. Oxygen Toxicity- is the result of higher than normal amounts of oxygen in the lower airways for a prolonged period of time as a FiO2 (fraction inspired oxygen) greater than 50-70% for longer than 72 hours. This prolonged exposure may lead to ciliary dysfunction, impaired mucous removal fibrosis of alveolar capillary membrane, and respiratory distress syndrome.

16. Early Symptoms: increase respiratory rate, dyspnea, coughing, fatigue, lethargy, malaise, restlessness, paresthesias (numbness) in the extremities, nausea, vomiting and anorexia

19. Respiratory care equipment that allows the patient to inhale some ambient air along with the delivered oxygen

20. In low flow sys, gas is delivered via small bore tubing at a rate shown on the flowmeter

21. Low flow sys are generally used for clients who have a respiratory rate below 25 per minute and a regular and consistent respiratory pattern

22. Patient with COPD

23. They are contraindicated for clients who require carefully monitored concentrations of oxygen

24. Low flow administration devices include the nasal cannula, simple face mask, partial rebreathing mask, humidity tent, and oxygen tent

25. High-flow systems

26. Supply all of the gas required during ventilation in precise amounts, regardless of the client’s respiratory status.

27. Gas is delivered via a Venturi device and large-bore tubing placed near the client

29. Both low-flow and high flow system can deliver a variety of oxygen concentrations.

31. Simple mask- [administration guidelines in manual]

32. Venture mask- used frequently in patients with chronic hypercapnia; gives higher concentration than simple mask, used in mechanical ventilator

33. Orange- 50%

34. Pink- 40%

35. Green- 35%

36. Partial-rebreather mask- purpose is to increase FiO2 by allowing it to be inhaled from a reservoir. Exhaled air also enters the reservoir bag, allowing some rebreathing of CO2. Thus it increases the FiO2 by recycling expired oxygen. The partial rebreather bag must not totally deflate during inspiration to avoid carbon dioxide buildup. It delivers 60-90% at liters flow of 5-8L/min

37. Administration guidelines:

38. Follow procedure for simple mask

39. If the reservoir bag collapses ore than slightly during inspiration, raise the flow rate until you only see a slight deflation

40. Marked or complete deflation indicates insufficient oxygen flow; carbon dioxide will accumulate in the mask and bed

41. Keep reservoir bag from twisting and kinking

42. Ensure free expansion by making sure it lies outside the patient’s gown and bedcovers

43. Non-rebreathing mask- oxygen concentration at 60-90% with a liter flow rate of 10-15L/min

44. Administration guidelines:

45. Follow

46. Make sure the mask fits snugly

47. ….

49. After insertion, obtain a chest x-ray to confirm placement

50. Monitor the patient for bleeding, respiratory distress, pneumothorax, pain, coughing or hoarseness

51. Don’t use the catheter for about 1 week following insertion to decrease the risk of subcutaneous emphysema

52. Continuous positive airway pressure mask- is a continuous positive pressure above atmospheric pressure at the airway opening throughout the spontaneous breathing cycle

53. >contraindicated in patients w/ COPD, pneuomothorax

55. Whether client has COPD

56. The levels of o2 and co2 in the ct.’s arterial blood

57. The order for o2, including the administering device and the liter flow rate(L/min) of the percentage of oxygen

58. Vital signs; arterial blood gas levels; signs of hypoxia, hypercapnia, lung soundsImplementation- semi-fowler’s position, permits easier chest expansion and hence easier breathing<br />