1
Q
Why supplemental oxygen therapy?
A
- MSK function
- dec. inspired O2
- hypovolemia (loss hemoglobin)
- inc. metabolic rate
- atrial fib
- hypoventilation
- cyanotic
- hypoxia
2
Q
What are the early signs of hypoxia?
A
- drowsiness, confusion, restlessness
3
Q
SpO2
A
- estimated amount of oxygen in blood bound or carried by oxygenated hemoglobin
- compared to total amount of hemoglobin in blood
4
Q
What is FiO2
A
- concentration of oxygen that a person inhales
5
Q
What is room air FiO2?
A
21%
6
Q
What is the goal of O2 therapy?
A
optimal arterial O2 with lowest amount of affected dose of O2
7
Q
10 rights of medication
A
- right medication (oxygen)
- right dose (concentration)
- right client (check band)
- right route (delivery device)
- right time/frequency (continuous, with exercise)
- right documentation
- right reason
- right to refuse
- right education
- right evaluation
8
Q
Oxygen safety
A
- no smoking signs
- electrical equipment functional and grounded
- know location fo fire extinguisher
- know fire procedures
9
Q
Transporting with O2 safety:
A
1) adequate supply for transport time
2) oxygen cylinders are secured to prevent tipping/falling
10
Q
AHS Policy
A
- order is required: in emergency, RN or RT can make an order, and LPN =delegated with supervision of RN
11
Q
When is an RT consulted?
A
- non-rebreather masks. venturi masks, or nebulizers in excess of 0.50, or in symptoms of respiratory instability
12
Q
What devices are one-time use?
A
- tubing, masks, and cannula’s
13
Q
When do you need an order?
A
- transport = flow rate > 8L, 40% FiO2, RN, LPN
- RRT consultation
14
Q
Devices and reservoirs
A
- patient’s oropharynx and cannula
- patient’s oropharynx and volume of mask
- oropharynx, volume of mask, volume of tusks
- oropharynx, volume of mask, volume of bag
15
Q
Higher reservoir volume = ____________
A
higher volume of O2
16
Q
What is nebulization?
A
adding moisture or medication to inspired air
17
Q
Low flow devices?
A
- variable performance as Fi02 fluctuates based on breathing patterns
18
Q
Example of low flow devices?
A
- nasal cannula, simple masks, reservoirs
19
Q
High flow devices?
A
- fixed performance, Fi02 delivered because the device exceeds flow the patient breaths in
20
Q
Examples of high flow devices?
A
- venturi mask, large volume or high flow cold nebulizer
21
Q
Resevoir?
A
- area providing space where air can sit and remain available for patient to inhale
- draw anytime
- nasal cannula
22
Q
Five safety measures when administering oxygen?
A
- no smoking
- all electrical equipment functional and grounded
- locate fire extinguisher
- know fire protocol and evacuation route
- before transporting client, check oxygen level
23
Q
Low Flow Nasal Prongs (Cannula)
A
22-40%
1-6 L (normally 4L)
24
Q
Pros of Low Flow Nasal Prongs (Cannula)
A
- non-invasive
- inexpensive
- comfortable
- allows for talking/eating
25
Cons of Low Flow Nasal Prongs (Cannula)
- skin breakdown over ears
- easily dislodged
- drying to mucous membranes
26
High Flow Nasal Prongs/Cannula
6-15 L/min
5L = 50%
10L = 62%
15 L = 80%
27
Pros of High Flow Nasal Prongs/Cannula
- for clients who cannot tolerate face mask for prolonged periods
- low flow device
28
Cons of High Flow Nasal Prongs/Cannula
- drying to mucous membranes
| - skin breakdown over ears
29
Simple face mask (short term only)
40-60%
| 5-8L/min
30
Pros of Simple face mask (short term only)
- short term use (<12 hours)
| - easy to fit
31
Cons of Simple face mask (short term only)
- contraindicated in COPD
- hot and confining
- interferes with talking/eating
32
Simple face mask must be set to at least _____ or rebreathing of CO2 will occur.
5L
33
Face tent mask
8-10 L/min
40%
- for patients with facial trauma or claustrophobia
- plus cold nebulizer
34
Partial non-rebreather mask
```
40-70%
15L/min
- no one way valve
- reservoir bag = inflated
- severe/acute distress
- low-flow
```
35
Non-rebreathing mask flowrate/FiO2?
60-80%
15 L/min
- min 10L/min
36
Non-rebreathing mask
- low flow device
- reservoir bag = inflated
- severe/acute distress
- closed system
- 3 valves = prevents CO2 from entering reservoir
37
Oxymask
24%-90%
38
Venturi Mask
set flow rate as per colour-coded valve
- hot and confining
- for short term therapy
39
Venturi Masks benefits?
1) high flow
2) multiple FiO2
3) good for COPD
40
Humdification
>4L
no longer used = must wear AGMP
aerosol generating medical procedure = n95
41
Oral airway
curved device, keeps relaxed tongue positioned forward within mouth
- preventing tongue from obstructing upper airway
42
Indications for insertion of an artificial airway?
1) obstructed airway
2) dec. LOC
3) tracheobronchial secretion removal
43
Purpose of an oral airway?
prevent obstruction of the trachea
44
Measurement of an oral airway?
distance from corner of mouth to angle of jaw just below ear
45
Oral airway too small?
tongue not held in anterior portion of mouth
46
Oral airway too big?
tongue forced towards epiglottis and obstruct airway
47
Goal of oxygen therapy?
prevent/relieve tissue hypoxia
48
When is oxygen therapy discontinued?
- patient able to maintain SpO2 > 90% on RA for 24 hours
- VSS
- physician order
49
A ____ order is required to initiate oxygen therapy, except in an emergency situation.
physician
50
What is classified as an emergency situation?
- acute chest pain
• unstable angina
• other acute situations in which hypoxia is suspected.
51
Hypoxia
insufficient oxygen available to meet the metabolic needs of tissues and cells
52
What should a physician order include?
- O2 flow rate/FiO2
OR
- oxygen therapy protocol for O2 tritation
53
How often should monitoring of oxygen be?
- at least every 12 hours
