Docstoc

Oxygen Therapy Powerpoint

Document Sample
Oxygen Therapy Powerpoint Powered By Docstoc
					BY: Quijano, Albee Charis A.
   Racaza, Helen Marie V.

To: Ms. Phoebe Marie Ramas, RN
        Oxygen Therapy
• is the administration of oxygen as a
  therapeutic modality. Oxygen
  therapy benefits the patient by
  increasing the supply of oxygen to
  the lungs and thereby increasing the
  availability of oxygen to the body
  tissues.
           Indications
• Hypoxemia

• Heart failure

• COPD
     Oxygen Precaution
• No smoking
• Electric plugs and circuits
• Avoid use of flammable
  substances
           Related devices

• A pressure
  regulator is used to
  control the high
  pressure of oxygen
  delivered from a
  cylinder to a low
  pressure controllable
  by the flowmeter.
•   A flowmeter is
    used to control and
    indicate the flow of
    oxygen. Typiclal
    flow range is 0-15
    lpm.
•   A nebulizer can be used
    deliver nebulizable
    drugs such as albuterol
    or epinephrine into the
    airways by creating a
    vapor-mist from the
    liquid form of the drug.
    Nebulizers are also
    commonly used with
    room air in the home
    with an electric air
    pump
Supplying Oxygen Therapy
• Wall outlets connected to a large central
  tank of oxygen are usually provided in
  healthcare facilities.

• Liquid Oxygen Units
  Liquid oxygen is contained in thermally
  insulating tanks
  Large tanks are used by hospitals
  Small tanks can be used domestically
Liquid Oxygen Units
 Compressed O2
 in portable tanks may also
 be available

 Cylinders contain
 compressed gaseous
 oxygen.
• Oxygen
  Concentrator
    removes nitrogen from
    room air and
    concentrates O2
•   requires a battery pack
    or electrical outlet for
    power.
•   eliminates the need for
    buying oxygen cylinders
•   relieves client’s anxiety
    about running out of
    oxygen
•   expensive, noisy, and not
    portable; moreover, the
    client must still have
    backup oxygen in case of
    power failure.
      Transtracheal Oxygen
            Delivery
• A tracheostomy is a direct surgical
  opening into the trachea through the neck

• Oxygen may be delivered through the
  tracheostomy via color or an adapter

• A transtracheal catheter is a catheter
  placed into the tracheostomy to deliver O2
  directly into the trachea.
Transtracheal Oxygen Delivery
           Oxygen Hazards
• Oxygen toxicity develops when O2
  concentrations of more than 50 % are
  administered for longer than 48 to 72 hours.
  Prolonged use of high O2 concentration reduces
  surfactant production, which leads to alveolar
  collapse and reduced lung elasticity.
• Oxygen supports combustion, although it does
  not burn, high concentrations of oxygen will turn
  a small spark of fire into a large fire. Fire
  prevention precautions must be used near
  oxygen delivery systems.
 Evaluating Adequacy of Oxygenation

      SaO2     Arterial PO2        Comment
                              Normal arterial
95-100%      80-100 mmHg        values in healthy
                                people.
                              PO2>60 mmHg is
                                required to sustain
                                life and activity.
90%          60 mmHg
                                This level is NOT
                                normal in healthy
                                people.
                              Normal venous
                                values; a LETHAL
75%          40mmHg
                                arterial value in
                                ANYONE.
     Administering Oxygen
Critical Aspects:

• Attach the flow meter to the wall oxygen source.
• Assemble and apply the oxygen equipment
  according to the device prescribed (nasal
  cannula, face mask, or face tent)
• Turn on the oxygen flow using the flow meter,
  and adjust it according to the prescribed flow
  rate.
• Make sure that the oxygen equipment is set up
  correctly and functioning properly before you
  leave the patient’s bedside.
         Equipments:

• Oxygen Source
• Flow meter
• Nasal Cannula, Oxygen Mask, or
  Face Tent
• Prefilled humidification device
• Padding
            Assessment

• Assess the patient’s comprehension of
  oxygen therapy
• Assess the patient’s respiratory status,
  including respiratory rate, depth and
  rhythm. Breath sounds, color and pulse
  oximetry results.
• Assess nares and ears for skin breakdown.
          Procedural Steps

• Attach the flow meter to the wall oxygen
  source. If you are using a portable oxygen
  tank, attach the flow meter to the tank if it
  is not already connected. The flow meter
  regulates the amount of oxygen delivered.
• Assemble the oxygen equipment.
  Assembling the oxygen equipment readies
  the equipment for oxygen administration.
         Procedure Variation A
            Nasal Cannula

• Attach the humidifier to the flow meter. If
  you are not using a humidifier, attach the
  adaptor to the flow meter.
• Attach the nasal cannula to the humidifier
  or the adapter.
• Place the nasal prongs in the patient’s
  nares and then place the tubing around
  each ear.
• Use the slide adjustment device to tighten
  the cannula on place under the patient’s
  chin.
• Turn on the oxygen using the flow meter
  and adjust it according to the prescribed
  flow rate
• Ensures that the oxygen is delivered at the
  prescribed rate.
• Make sure that oxygen equipment is set up
  correctly and functioning properly before
  you leave the patient’s bedside.
       Procedure Variation B
            Face Mask
• Attach the prefilled humidifier to the flow meter.
  The humidification device must be attached to
  the flow meter to ensure delivery of humidified
  oxygen
• Attach the oxygen tubing connected to the mask
  to the humidifier. Prepares the tubing for oxygen
  delivery.
• Gently place the facemask on the patient’s face
  applying from the bridge of the nose to under the
  chin. Fits the mask snugly to the patient’s face
• Secure the elastic band around the back of
  the patient’s head. Make sure the mask fits
  snugly but comfortably.
• Turn on the oxygen using the flow meter
  and adjust it according to the prescribed
  flow rate. Ensures that oxygen is delivered
  at the prescribed rate.
• Make sure that the oxygen equipment is
  set up correctly and functioning properly
  before you leave the patient’s bedside.
       Procedure Variation C
            Face Tent
• Attach the prefilled humidifier to the flow meter.
  Ensures delivery of humidified oxygen which
  prevents the drying of airways that occurs with high
  oxygen flow rates.
• Attach the oxygen tubing to the face tent. Ensures
  adequate oxygen delivery.
• Attach the oxygen tubing to the humidifier.
  Prepares the tubing for oxygen delivery.
• Gently place the face tent in the front of the
  patient’s face making sure that it fits under the
  chin. Ensures a proper fit.
• Secure the elastic band around the back of
  the patient’s head. The elastic band must
  go around the back of the patient’s head
• Turn on the oxygen using the flow meter
  and adjust it according to the prescribed
  flow rate. Ensures that oxygen is delivered
  at the prescribed rate.
• Make sure that the oxygen makes sure that
  the oxygen equipment is set up correctly
  and functioning properly before you leave
  the patient’s bedside.
Evaluation:
• Auscultate breath sounds every 2 to 4 hours as
  indicated.
• Monitor pulse oximetry or arterial blood gas
  results. Evaluate skin areas that come in contact
  with oxygen delivery system for signs of skin
  breakdown.

Patient Teaching
• Demonstrate oxygen administration to the
  patient and caregiver. If the patient will be
  continuing oxygen therapy at home.
• Explain the importance of immediately reporting
  shortness of breath of any difficulty breathing.
                      Home Care
• Explain to the family and caregiver where to obtain oxygen
  equipment and what services are available. Make sure they
  choose a supplier who has 24 hours emergency services.

• Instruct the patient and caregiver about oxygen therapy and its
  use as well as safety measures that they must institute.

• Teach the patient and caregiver to clean the nasal cannula or face
  mask with soap and warm water when it becomes soiled.

• Provide the patient and caregiver with contact information of
  health care personnel who can be reached for advice and
  emergencies.

• In the home, liquid oxygen and oxygen concentrator are more
  commonly used than portable oxygen tanks. Liquid oxygen may
  be kept in small portable containers; an oxygen concentrator
  removes nitrogen from room air and concentrates O2.
   Oxygen Delivery Systems
• Low-Flow Devices:
 deliver oxygen at flows that are less than the
 patient's inspiratory flowrate


• High-Flow Devices:
 can accurately deliver predetermined
 oxygen concentration to the trachea up to
 40%.

 Aerosol masks, tracheostomy collars, T-tube
 adapters, and face tents can be used with
 high-flow supplemental oxygen systems.
                 Nasal Cannula
  Delivery                                                       Nursing
                       FIO2               Discussion
  Method                                                      Responsibilities
                 1L/min=24%            -relatively           -check frequently that
                 2L/min=28%            comfortable           the prongs are in the
                 3L/min=32%                                  patient’s nose
                 4L/min=36%            -patients can eat,
                 5L/min=40%            talk, and cough with -assess for dryness of
is a thin tube   6L/min=44%            a nasal cannula in   the nasal mucosa
with two small   ☻ It can only         place
nozzles that     provide oxygen at                          -humidify flow at
                 low flow rates, 1-6   -works best if the   rates above 3L/min
protrude into    litres per minute
the patients                           patient breathes     (flow at rates above
                 (LPM), delivering
                                       through his nose.    3L/min are drying)
nostrils.        a concentration of
                 24-40%. Flow
                 rates greater than
                 4 liters per minute
                 should also be
                 used with a
                 humidifcation
                 system.
Nasal Cannula
                    Simple Face Mask
                    5-10L/min=40-   -requires flow rates     -place face mask
a clear, flexible   60%             greater than 5L/min      securely over the
mask that covers                    to prevent               mouth and nose.
the nose and                        accumulation and         -elastic straps fit
mouth and                           rebreathing of           around the head to
delivers oxygen                     exhaled CO2 from         hold the mask in place.
into the mask.                      within the mask.         Place the straps well
☻used for non-                      -masks are not easily    above the ears to
life-threatening                    tolerated because        prevent skin irritation
conditions but                      they fir tightly and     and breakdown.
which may                           keep heat from           -place gauze or other
progress in time,                   radiating from the       soft material beneath
such as chest                       face, making patients    the straps to prevent
pain (possible                      feel hot.                irritation.
heart attacks),                     -talking is muffled by   -check the skin around
dizziness, and                      the mask, and it must    the mask frequently.
minor                               be removed for the       -check the skin over
hemorrhages.                        patient to eat or        the ears where the
                                    drink.                   mask strap rubs.
Simple Face Mask
           Partial rebreather mask
                                    -allows higher FIO2     -maintain the flow at
                6-15L/min=50-       levels to be            a high enough rate to
                90%                 delivered because       prevent the reservoir
                ☻It is considered   O2 is collected in      bag from collapsing
                a low-flow system   the reservoir bag for   during inhalation.
                                    inhalation.
uses the                            -exhalation ports
reservoir bag                       allow most exhaled
to capture                          air to escape.
some exhaled                        -several types are
gas for                             available.
rebreathing                         -can deliver an FIO2
                                    above 50% at flow
                                    rates of 6-15L/min.
                                    -patient rebreathes
                                    some exhaled air
                                    along with O2.
Partial rebreather mask
         Nonrebreather mask
                6-15L/min=70- -contains only O2,    -maintain the flow at
similar to the  100%          which allows          a rate high enough
partial                       higher FIO2           to prevent the
rebreathing                   delivery. An FIO2     reservoir from
mask except it                of 60-100% can be     collapsing during
has a series of               delivered at flow     inhalation.
one-way valves.               rates of 6-15L/min.
One valve is                  -This mask is the
placed between                only external
the bag and the               device capable of
mask to                       delivering an FIO2
prevent                       of 100%.
exhaled air
from returning
to the bag
Nonrebreather mask
                     Venturi Mask
                  24-50%   -the cone-shaped       -the adapter
                           adapter at the base    indicates the
a cone-shaped              of the mask allows a   required oxygen flow
adapter that               precise FIO2 to be     rate needed to deliver
serves as a                delivered. This is     the desired FIO2.
mixing valve to            very useful for        ensure that the flow
control the                patients with          is set at the rate
amount of O2               chronic lung           specified to deliver
and room air               disease.               the FIO2 desired.
that flows                 -exhalation ports
through the                keep CO2 buildup to
mask.                      a minimum.
Venturi Mask
                         Face Tent
a large, open     8-12L/min=30-   -less reliable than -check the skin over
plastic mask      55%             a face mask for     the ears where the
that fits under                   delivering precise mask strap rubs.
the chin. It is                   FIO2 levels.
open at the top                   -does allow
and is held in                    moderate-to high-
place with an                     density aerosol
elastic band                      delivery for
around the                        humidification.
head.
Face Tent
              Tracheostomy collar
                     4-10L/min=24-   -it is possible to deliver   -watch for water
                     100%            both high FIO2 and high      accumulation in
                                     humidity with a              the tubing.
a small, cup-                        tracheostomy collar.
                                     -large-bore tubing is
shaped device
                                     used to deliver
that fits over the                   humidification to the
tracheostomy                         trachea; however, water
opening and is                       frequently condenses
held in place                        inside the tubing and can
with elastic                         be accidentally drained
straps around                        into the tracheostomy.
the neck.                            Usually, a water trap of
                                     some sort of placed in
                                     the tubing to prevent
                                     this problem.
Tracheostomy collar
                              T-Piece
                   4-10L/min=24- -Oxygen humidity     -Take care that the
                   100           are delivered into   oxygen delivery
A T-shaped                       one end of the T     tubing does not pull
plastic piece;                   and exhaled          on the T-piece, which
the bottom of                    through the other    can dislodge the
the T fits                       end.                 tracheostomy tube
directly and                                          and create an airway
tightly onto the                                      emergency.
tracheostomy
tube.
T-Piece

				
DOCUMENT INFO
Shared By:
Stats:
views:1664
posted:11/30/2011
language:English
pages:44
Description: oxygen therapy power point lesson