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TL O2 administration
Campus Lab Skill - O2 administration from lag
| Question | Answer |
|---|---|
| What is the goal of oxygen therapy? | to relieve hypoxia |
| When is O2 therapy indicated? | only when the patient exhibits signs of hypoxia or lab/diagnostic test indicate the need |
| What labs/diagnostics determine O2 status? | ABGs, Saturation, EKG, anemia (hgb/hct) |
| What are some safety precautions to follow with O2 therapy? | Highly combustible – no smoking signs; teach patient/family/visitors; 5-10 ft away from sources of sparks/heat/fire; electrical equipment in good working order/grounded; makes sure portable tanks are adequately full |
| List several items to avoid when O2 is in use (AACSPPCGCFEW)? | Alcohol, aerosols, cleaning fluids/solvents; perfumes; petroleum products; cigarettes; gas stoves/heaters; candles; fireplaces; electric razors; wool (sparks) |
| Name two ways in which O2 is supplied. | bedside via tanks or more commonly through wall piped systems in acute care settings |
| Name 6 methods of O2 delivery. | Nasal cannula (N.C.), nasal catheter, face mask, trach collar, transtracheal catheter, mechanical ventilator |
| Name 3 types of O2 face masks. | Simple, venturi, non rebreather |
| What are the indications for O2 delivery via nasal cannula? What is an advantage of using nasal cannula? | simple/comfortable device for low flow O2 delivery (<6 L/min) |
| How percentage of O2 is delivered by nasal cannula at 1 L/min? | 24% |
| How much does the percentage of O2 increase with each additional L/min by nasal cannula delivery? | 4% |
| How much oxygen is being delivered by nasal cannula at 2 L/min? | 28%; |
| Give four nursing considerations for the patient receiving oxygen via nasal cannula. | humidification may be required if the patient experiences mucosal drying or if O2 is delivered at 4L/min or higher; Check pressure points for breakdown; clean equipment; Mouth breathers may require alternate delivery method |
| What are the indications for a nasal catheter? | when a continuous uninterrupted flow is required- rarely used |
| What O2 concentration is delivered by nasal catheter? | approximately 30% (6L/min) |
| How often are nasal catheters used? What is a potential complication? How often should a nasal catheter be changed? | Rarely used, mucosal trauma, change q 8 hours |
| What are the benefits of using transtracheal O2 (TTO)? | less O2 to treat hypoxia because less is lost to environment = less $; No nasal irritation; Greater mobility/comfort/cosmetic; May reduce SOB and work of breathing; Improved appetite (sense of smell/taste); reduced polycythemia; decreased hospital stay |
| What are the Sa O2 and Pa O2 goals with transtracheal O2? | SaO2 91-95%; PaO2 65-80% |
| What is the normal O2 concentration delivered by transtracheal methods? | 60-80% |
| What potential complications should the nurse be aware of with Transtracheal O2? | increased risk for infection and obstruction |
| How often is a transtracheal catheter changed? | usually q 7 days |
| Name some situations simple O2 mask would be indicated (4)? | for mouth breathers, to deliver humidified or heated humidified air, short term therapy |
| What is the concentration of O2 usually delivered via simple face mask? | 30-60% (6-8L/min) |
| When are rebreather/nonrebreather masks called for? | When High O2 concentrations are needed |
| What is the normal concentration of O2 delivered by rebreather/nonrebreather masks? | 80-90% (10L/min) |
| Who cannot have a rebreather/nonrebreather mask? | COPD patients |
| What is the rule for the reservoir bag? | must not totally deflate |
| When are venturi mask indicated? | when precise amounts of O2 are required |
| How are Venturi mask O2 concentrations regulated? | by liter flow and appropriate adaptor |
| Which clients is the Venturi mask most appropriate for? | COPD patients |
| What device does our patient with a venturi mask use when it’s time to eat? | switch to nasal cannula when eating |
| When PaO2/SaO2 numbers indicate that the patient requires O2 delivery at home? | When PaO2 is < 55mmHg or O2 saturation (SaO2) < 88% (room air, rest, exertion, exercise) |
| What device is usually used to deliver O2 from the source to the client at home? | Nasal cannula |
| If the patient is receiving oxygen at home through a trach what attachments are utilized? | Tpiece or trach collar |
| Name the three types of oxygen systems used for home O2. | compressed O2, Liquid O2, Oxygen concentrators |
| Define H cylinders. | compressed gas in a large cylinder – stays at home |
| Define E cylinder. | compressed gas in a small tank that can be transported |
| How does liquid O2 work? | Stored at very cold temperatures. Liquid changes to gas when released from tank |
| How does liquid O2 compare to compressed air? | More expensive, takes up less space, easy to transfer to portable tanks |
| How does an O2 concentrator work? How does it compare to liquid O2? What precaution is necessary? | It is an electric device that separates O2 out of room air; less expensive than liquid O2, needs tank of stand by O2 ready at hand |
| How should cannulas and masks be cared for at home? | wash once or twice a week with liquid soap; rinse thoroughly; change to a new cannula/mask q 2-4 weeks |
| How should a patient care for TTO with a scoop 1 catheter at home? | Inspect opening for redness/swelling; clean BID Qtip & hydrogen peroxide; clean neck with Ivory or Dove; maintain patency by irrigating with 1.5mL NS 2-3x/day, inserts rod to clean; remove & clean catheter < 1x/wk with warm h2o & antibact soap |
| How long will the patient with a scoop 1 catheter take antibiotics? | about 1 week |
| How often are scoop 2 catheters removed and cleaned? How often should they be replaced? | BID, q 90 days |
| Name 6 hazards of O2 therapy (PRASCI). | respiratory depression – esp. COPD; atelectasis; substernal chest pain, pulmonary O2 toxicity, Infection, combustion |
| Why is respiratory depression a possible complication of O2 therapy? | COPD patients drive to breath is linked to hypoxemia |
| Why is atelectasis a potential problem with O2 therapy? | High O2 concentrations wash out nitrogen which is a component of surfactant |
| When is substernal chest pain possible with O2 therapy? | with high concentrations of O2 (70-100%) after several hours |
| What is pulmonary O2 toxicity? | lung damage/fibrosis secondary to prolonged exposure to higher concentrations of O2 (usually greater than 50% for more than 24 hours) |
| Why is infection a potential problem with O2 therapy? | equipment can be contaminated, decreased immune response |
| How can the nurse prevent infection with O2 therapy? | always flush catheter with normal saline |
| What are the early signs of hypoxemia (TTHM -rac)? | Tachycardia, tachypnea, HTN (resulting from sympathetic vasoconstriction), Mental changes – restlessness, anxiousness, confusion |
| What are the late signs of hypoxemia (ABCDDLHHLHH)? | severe occipital HA and hypotension (vasodilation), lethargy, drowsiness, bradycardia, arrhythmia (PVCs), Dyspnea, Cyanosis |
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Perseverandovercome
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