Transcript OXYGEN THERAPY POWERPOINT

OXYGEN THERAPY
MELANIE MORANO, JD, MSN, RN
“I have had a horribly busy day converting oxygen to carbon dioxide.”
-Unknownoxygentherapycentre.co.uk
STRUCTURE OF THE LUNGS
UPPER AIRWAYNose, pharynx, larynx, epiglottis
Function is to warm, filter and
humidify inspired air
Slideshare.net
Pittsburghdentalsleemedicine.com
Medicine.academic.ru
Hattiesburgamericn.com
STRUCTURE OF THE LUNGS
LOWER AIRWAY
Trachea, bronchi,
bronchioles, alveoli
Function to conduct air,
clear mucous, and produce
surfactant
slideshare.net; mikecurtis.org.uk; sydney.edu.au
boundless.com; ivyroses.com; medicinenet.com
FUNCTION OF THE LUNGS
ENERGY SUPPLY
Ventilation
Respiration
Perfusion
123rf.com
quora.com
slideplayer.com
ausmed.edu
FUNCTION OF THE LUNGS
OXIDATION
WHAT IS THE FUNCTION OF THE CELLS IN THE BODY?
WHAT HAPPENS WITHOUT A CONTINUOUS SUPPLY OF OXYGEN? The
WHAT HAPPENS AS A RESULT OF OXYDITATION?
FUNCTION OF THE LUNGS
DYSPNEA
TACHYPNEA
ORTHOPNEA
HYPOXEMIA
STRIDOR
RESPIRATORY CHARACTERISTICS OF CHILDREN
Rapid respiration (30-55 per min)
Abdominal breathing
Irregular in rate and depth
Chest wall is thin with little muscle
Ribs and sternum easily seen
Round thorax
At risk for URI’s
Airways are short
my.clevelandclinic.org
RESPIRATORY CHANGES IN OLDER ADULTS
16-24 breaths per minute
Lung tissues less elastic
Power of muscles reduced
Airways collapse more easily
Barrel or elliptical shaped thorax
slideshare.net
123rf.com
WHAT IS OXYGEN?
Why is oxygen essential?
Oxygen form what percent of room air?
Does oxygen require a prescription?
ducksters.com
WHEN DOES A PATIENT NEED OXYGEN?
Hypoxemia
Hypoxia
4 types of hypoxia- hypoxemic,
circulatory, anemic, and histotoxic
When hypoxemic- what do you need?
copdbfrg.org
WHEN DOES A PATIENT NEED OXYGEN?
SIGNS AND SYMPTOMS – A CHANGE IN THE RR
ANXIETY CHANGES IN MENTAL STATUS
PALLOR
DECREASED PULSE PRESSURE
DYSPNEA
INCREASE IN BLOOD PRESSURE CHANGE IN HEART RATE
CENTRAL CYANOSIS
PERIPHERAL CYANOSIS
CONFUSION
DROWSINESSACTS “DRUNK”
LETHARGY
CONFUSION COOL EXTREMITIES
COMA
thefruitdoctor.com; enwikipedia.org
OXYGEN ADMINISTRATION
What is oxygen therapy?
What is the goal of oxygen therapy?
Why must oxygen be humidified?
When/how often can oxygen be administered?
How is oxygen measured?
123rf.com
HOW IS OXYGEN PROVIDED?
HOSPITALwall outlet, flow meter
nlm.nih.gov; enwikipedia.org; pengyam.com
oxygen cylinder
HOW IS OXYGEN PROVIDED?
HOMEOXYGEN CONCENTRATOR
COMPRESSED OXYGEN
LIQUID OXYGEN
CYLINDER
caremedical.com; blog.copdfoundation.org; premiermedicalcorp.com
OXYGEN MONITORING
Venous Lab WorkHGB AND HCT
Arterial Blood Gases (PaO2-normal 80-100; hypoxemia<60)
Pulse oximetry (SaO2- normal 95-100; hypoxemia < 90)
Observation/monitoring S/S
amazon.com.co.uk; bloodwork.com; facweb.northseattle.edu
OXYGEN MONITORING
ARTERIAL BLOOD GASESDrawn from an artery
Apply pressure after drawing
Immediately place specimen on ice
Blood will be bright red
Normal PaO2 – 80-100 mm Hg
health.kernan.org; webcls.utmb.edu
OXYGEN MONITORING
PULSE OXIMETER
Measures SpO2- oxygen saturation of hemoglobin
Uses light signals
Normal SpO2 – 95-100%
Many causes for inaccurate readings
Monitor skin integrity under sensor
Commons.Wikipedia.org; donaldmaler.com; emedicine.Medscape.com
OXYGEN MONITORING
Monitoring in ChildrenReposition the probe
Photodetector
Hazards
Aboutkidshealth.ca; Premies.about.com; Medubc.ca;
Amnch.ie; Blog.babyheartscreening.com
NASAL CANNULA
Used for flow rate of 1-6 L/min
Provides oxygen concentration of 24-44%
Does not hinder eating, drinking and speaking
Considered low-flow
starshealthcare.com; bioserve.co.nz
NASOPHARYNGEAL CATHETER
Catheter is inserted in one nostril with the end of the
catheter resting in the oropharynx
Remove and clean and change to other nostril
every 12-24 hours
Low Flow
Hazards
ichrc.org; mediconsurgical.com
MASKS
4 typesSimple Face Mask
Partial Rebreather
Nonrebreather
Venturi mask
FIO2= Fraction of Inspired Oxygen Delivered
nursingcrib.com
SIMPLE FACE MASK
FIO2-40-60%; 5/6-8 L/min – low flow
Fit mask
Humidifier
Has vents
Never apply less than 5L/min
easyoxygen.com.au
PARTIAL REBREATHER MASK
8-11/15 L/min; FIO2 50-75%- low-flow
A mask with a reservoir bag
Bag must remain partially inflated
Make sure reservoir does not twist, kink or
become deflated
Mixes with room air through ports
cram.com
NONREBREATHER MASK
Of low flow systems, offers highest concentration
Valves open during expiration and close during inhalation
12 L/min= 80-100% FIO2Oxygen
Maintain flow rate
Low flow or high flow (in theory if sealed well)
Monitor closely
suggestkeyword.com
VENTURI MASK
High- flow
FIO2 delivered 24-55%; flow rates 4-10 L/min
Air entrapment port to mix oxygen with room air
Fit snugly, free of kinks
Is most reliable and accurate method
Be sure side ports are open
medical-dictionary.freedictionary.com; shareslide.net
ADULT OXYGEN HOOD/FACE TENT
A face tent fits over the client’s chin with the top extending
halfway across the face
fmhmedical.com
AEROSOL MASK
Useful for client who requires high humidity after
extubation or after upper airway surgery or with thick secretions
Assess that the aerosol mist escapes from the vents of the delivery
system
Empty condensation from the tubing
Remove and clean the tubing at least every 4 hours
May also deliver medication to the lungs
intersurgical.com
TRANSTRACHEAL/TRACHEOSTOMY
Trach collar or mask- can deliver high humidity and O2 to
client with tracheostomy
T tube useful for weaning patients from
mechanical ventilation
Transtracheal
Use at home
tto2.com; shopcatheters.com; downloads.lww.com
OXYGEN THERAPY FOR CHILDREN
Mode of delivery is selected on the basis of the concentration needed
and the child’s ability to cooperate in its use
Inspect toys for safety and suitability
suggestkeyword.com
makeit-loveit.com
OXYGEN THERAPY FOR CHILDREN
OXYGEN TENT- not used in US much now
Highly humidified
Provides lower concentration levels
(FIO2 30-50%)
pinterest.com
OXYGEN THERAPY FOR CHILDREN
OXYGEN HOOD-
Provides cooled humid air
Check O2 with analyzer every 4 hours
May cover client with light blanket
Monitor client’s temperature frequently
Use at least 4-5 L/min to maintain oxygen
concentrations and remove the exhaled carbon dioxide
The oxygen should not be blown directly into the face
gallery4share.com; hospitalnet.com
CPAP/BIPAP
What is the difference between CPAP and BIPAP?
Used to treat sleep apnea, heart failure, preterm infants
HYPERBATIC OXYGEN THERAPY
The patient is placed in a cylinder chamber
Used to treat air embolism, gangrene, tissue necrosis,
enhance wound healing
mediassistcare.com
OXYGEN TOXICITY
Can occur when too high a concentration of oxygen (greater
than 50%) is administered for an extended period (> 48 hours)
S/S- substernal discomfort, parasthesias,
dyspnea, restlessness, fatigue, malaise,
respiratory difficulty, lung infiltrates
OTHER RISKS OF OXYGEN THERAPY
Oxygen Induced Carbon Dioxide NarcosisIn some COPD or cystic fibrosis patients the stimulus for
breathing is a decrease in oxygen level. Administering high
levels of oxygen can depress the respiratory drive and cause
respiratory distress
Follow oxygen orders
webmd.com
OTHER RISKS OF OXYGEN THERAPY
INFECTION
Bacterial cross- infections
Irritation and skin breakdown
downloads.lww.com
OTHER RISKS OF OXYGEN THERAPY
FIRE SAFETY
Oxygen is combustible and can cause fires
Place “No Smoking” signs, avoid open flames
Check equipment for sparks
Avoid synthetic clothing
Avoid oils- petroleum jelly, lotions
Notify fire department
Use with caution around other heat sources
Store cylinders and other storage devices safely
dirtyworldnews.com; reddit.com
OTHER RISKS OF OXYGEN THERAPY
MISCELLANEOUSLiquid oxygen
Fires can start in the OR
Cylinders can be dangerous
outpatientsurgery.net
HOME OXYGEN ADMINISTRATION
INSTRUCTFollow prescription for use
Fire safety
When to call HCP
Proper use of equipment
Use of humidifier
How and when to order O2
Notify fire department, phone and power companies
Notify neighbors in case of emergency
Check oxygen supply often
nhlbi.nih.gov; pho2.ca
HOME OXYGEN ADMINISTRATION
When traveling in car place tank on floor behind front seat
Infection prevention Keep follow-up appointments
Protect skin integrity
How to adjust flow meter
Post vendor number
Use water-based lubricant
Do not stop or change flow
Take good care of teeth and gums
clippard.com
HOME OXYGEN ADMINISTRATION
Notify airline 2 weeks in advance if traveling
Proper care and cleaning
Diet improvements
Post power, fire and phone
company numbers
Post “No Smoking” sign
Don’t allow anyone to smoke
in the house
Use of portable equipment
homefrontairandmedical.com; mda.org
WHEN TO CALL HCP
(Make sure oxygen equipment is working before your call)
Adults- Lots of headaches, nervous, blue lips/fingernails,
drowsy, confused, dyspnea
Children- breathing faster, flaring nostrils, grunting noises,
pulling in cheek, dusky, gray or bluish color, irritable, short of
breath, limp
didcothealthcentre.com
CULTURAL INFLUENCES
Religious and cultural ceremonies
Home environment
Lifestyle
Location
Language and educational barriers
enwikipedia.org
ASSESSMENT OF CLIENT ON OXYGEN THERAPY
Skin
Lab Results
Medications
Respiratory status
Complaints
worldwidewounds.com
DOCUMENTATION FOR CLIENT RECEIVING
OXYGEN THERAPY
O2 flow rate
Skin assessment
Respiratory status
Vital signs, capillary refill
Lung sounds
Consults with HCP
Mental status
Emotional support
Lab values
Teaching
gocollege.com
NURSING DIAGNOSES
Ineffective Airway Clearance
Impaired Gas Exchange
Ineffective Breathing Pattern
Impaired Spontaneous Ventilation
Dysfunctional Ventilatory Weaning Response
what-when-how.com
THE END
“We’re not just any star stuff, most of which is humdrum hydrogen
and listless helium. Our bodies include fancier oxygen, nitrogen,
phosphorous, and a few other herbs and spices.” Seth Shostak
Top10archive.net