oxygen therapy Correct Answer--purpose: to relieve hypoxemia and
hypoxia
-goal: use lowest fraction of inspired oxygen (FiO2) for acceptable
blood oxygen level without causing harmful side effects
oxygen therapy hazards - oxygen toxicity Correct Answer--related to the
concentration of oxygen delivered in therapy if lung disease is present--
risk of reducing tissue integrity
-dyspnea, non-productive cough, chest pain, lung crackles--prevent by
using lowest level of oxygen for their needs--done by titrating the
oxygen
-prolonged exposure can lead to atelectasis, pulmonary edema, and
hemorrhage
,oxygen therapy hazards - drying of mucous membranes Correct Answer-
happens commonly in patients who have more than 4 L of oxygen flow
oxygen therapy hazards - infection Correct Answer--can come from
tubing and cannula--be sure to change them out as well as the nebulizer
according to hospital policy--can be as often as 24 hours
-check for pressure points--nasal cannulas can cause device related
pressure injuries (around the face, in the nose, around the ears)--
collaborate with respiratory therapy
oxygen therapy hazards Correct Answer--check prescription
-use humidification if delivered at 4 L/min or more
-check skin for pressure points
-clean cannula, mask
-collaborate with RT
oxygen delivery systems - type used depends on... Correct Answer--
required oxygen concentration
-oxygen concentration that can be achieved by a delivery system
-importance of accuracy and control of the oxygen concentration
-patient comfort
-use of humidity
-patient mobility
,oxygen delivery systems - classified by rate of O2 delivery - Low-Flow
Oxygen Delivery Correct Answer--nasal cannula, Facemask (simple,
partial rebreather, non-rebreather)
-designed to deliver a lower fraction of inspired oxygen--they do not
supply the total O2 volume because the oxygen is diluted and as the
patient breathes room air--they are easy to use, they are comfortable, and
the amount of oxygen delivered can vary
oxygen delivery systems - classified by rate of O2 delivery - High-Flow
Oxygen Delivery Correct Answer--Venturi mask, Aerosol mask, face
tent, high flow nasal cannula, Tracheostomy collar, T-piece
-designed to supply total oxygen volume by adjusting the amount of
room air entrained in the delivery system
-critically ill patients
nasal cannula Correct Answer--flow rates of *1 to 6 L/min*
-O2 concentrations of 245 to 44%
-flow rate >6 L/min does not increase gas exchange because anatomical
dead space is full
-often used for chronic lung disease or long-term therapy
-monitor for any skin breakdown!
-higher rates of flow will cause more irritation to the mucosa!
simple facemask Correct Answer--minimum of *5 L/min*
-delivers O2 up to 40% to 60% for short-term therapy or emergency
-ensure appropriate fit
, -monitor for skin breakdown!
partial rebreather mask Correct Answer--flow rate of *6 to 11 L/min*
-provides 60% to 75%
-patient rebreathes 1/3 exhaled tidal volume
-bag needs to be slightly inflated at the end of expiration!
non-rebreather mask Correct Answer--delivers highest O2 level
-can deliver FiO2 greater than 90%
-used for unstable clients who may require intubation
-ensure valves are patent and functional
-one-way valve between the mask and the reservoir
-flaps prevent room air from entering
-inflate the bag before applying to the patient
-short-term fix before a long-term situation (intubation or stabilization)
high-flow nasal cannula Correct Answer--*30 L/min to 60 L/min*
-combination of heat and humidity minimize damage to mucous
membranes
-less drying, more tolerated, less likely to cause skin breakdown and
mucous membrane breakdown
-humidity can help increase mucous clearance
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