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| Signs of hypoxemia | restlessness, irratibility, confusion, difficulty in breathing, difficulty in breathing, tachypnea, abnormal lung sounds, cyanosis, retractions, dysrhythmias, acid-base imbalance, decreased oxygen saturation
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| Common Causes of Hypoxia (Obstruction of the Airway) | Occlusion by the tongue or mucous secretions
Inflammation for croup, asthma, tracheobronchitis, or laryngitis
Occlusion of foreign body (e.g., aspiration or vomitus)
Chemical and heat burns with inflammation
COPD causing airway collapse
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| Common Causes of Hypoxia (Obstruction of the Airway) | Near drowning, occlusion by water
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| Common Causes of Hypoxia (Restricted Movement of the Thoracic Cage or the Pleura | Abdominal surgery (incisional pain restricting movement)
Chest injuries (e.g. flail chest or penetrating wounds)
Pneumothorax (spontaneous or traumatic)
Extreme obesity (restricts thoracic movement)
Diseases (spinal arthritis, peritonitis
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| Common Causes of Hypoxia (Restricted Movement of the Thoracic Cage or the Pleura | Diseases (spinal arthritis, peritonitis , kyphoscoliosis)
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| Common Causes of Hypoxia (Decreased Neuromuscular Function) | Depressed central nervous system (drugs including sedatives and anesthesia agents; brain trauma, stroke,)
Coma (diabetic, uremic, and from brain injuries
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| Common Causes of Hypoxia (Decreased Neuromuscular Function) | Diseases (multiple sclerosis, myasthenia gravis, poliomyelitis, or Guillian-Barre Syndrome
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| Common Causes of Hypoxia (Disturbances in Diffusion of Gases) | Diseases (pulmonary fibrosis or emphysema)
Trauma (contusion)
Emboli, fat embolus
Tumors, benign or malignant
Respiratory distress syndrome
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| Common Causes of Hypoxia | High altitude (decreased oxygen in the atomosphere)
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| Safety Consideration Boxes: Hypoxemia (page 510) | Hypoxemia poses a dangerous threat to patients
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| Safety Consideration: Teamwork for Hypoxemia Patients (page 510) | Persistent hypoxic states requires the collaboration of a team consisting of a physician, a respiratory therapist, a laboratory technologist, and a nurse
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | Place a "No Smoking Oxygen in Use" sign on the patient's door and at the foot of the bed or over the head of the bed.
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | Remind visitors about the hazard of smoking when oxygen is in use. Teach the family to smoke only far away (outside the building) from the room where oxygen is in use.
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | Check all electrical devices for frayed wires, and to see that they are in good working order, to prevent short-circuit sparks that could cause a fire.
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | Avoid use of bedclothes and pajamas that are made of material that can generate static electricity. Cotton fabrics are best
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | Do not use oils, grease-based ointments, alcohol, ether, acetone, or other flammable materials on or near that patient when oxygen is in use
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | If oxygen cylinders are being used, handle with care. Be certain they are strapped securely into stands and transport devices to prevent them from falling. Situate the cylinders away from heat and heavy traffic pathways
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| Safety Considerations: Safety Alert (Oxygen Therapy Safety (page 518) | Monitor the patient for skin irritation from the oxygen delivery device
Assess for dry mucous membranes, indicating a need for humidification to prevent tissue breakdown and increased risk for infection
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| Safety Considerations: Safe Oxygen Flow Rates (page 519) | Patients with obstructive lung disease should be given only 2 to 3 L/min because higher concentrations of oxygen reduce the respiratory rate.
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| Safety Considerations: Safe Oxygen Flow Rates (page 519) | This is because their incentive to breathe comes from lower oxygen levels rather than higher carbon dioxide levels in the blood.
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| Safety Considerations: Safe Oxygen Flow Rates (page 519) | These patients commonly have a continuous high level of carbon dioxide
Check orders for oxygen carefully and always verify high flow rates with the prescribing care provider.
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| Safety Considerations: Safety Education (page 521) | Teaching safety precautions for the home care patient is especially important because there is no medical supervision after the nurse's visit
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| Safety Considerations: Oxygen Safety (page 535) | Observe safety measures to prevent explosion or fire
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| Safety Considerations: Call Bell (page 537) | it is vitally important for this patient to have the call bell at hand at all times
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| Safety Considerations:Memory Jogger (page 538) | Teach safety measures to the patient and family regarding oxygen use. Explain ways to conserve energy to promote independence. Educate patients and family on suctioning techniques.
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