rsin

ww
om es.c tur

ur w.n

sin
ww
s.c ture om

ur w.n

sin
w
s.co ure t m

.nur ww

sin

rsin

c g-le

ww

ur w.n

sin

c g-le

OXYGEN THERAPYng-lec si .nur w ww

.nur ww w

sin

tur -lec g

es.c

Indications for O2 Administration om .com Respiratory Compromise ri.e.:com es es. cyanosis, partially obstructed tairway, tachypnoea es.c es.c ctur ctu chest pain, shock c ur ctur - Cardiac Compromisele i.e.: -le - -le -le - Neurologicalursing i.e.: stroke, spinal injuries ursing deficits sing sing r .n .n .nur Prescribing O2 ww ww ww w w w Several ways of prescribing oxygen amount

om Flow per minute (L/min) s.com om es.c Percentage (%) e es.c tur tur tur -lec -lec -lec g FiO2 sing sing rsin .nur .nur w w ww ww Nasal Cannula
c g -l e s.c ture om
sing .nur w -le om es.c ctur
w.n ww
s.co ure ect m
w sing .nur -l

ww

ur w.n

sin

tur -lec g

es.c

rsin

ww
s.c ture om

lec ingurs

s.c ture

om
si .nur w n

tur -lec g

es.c

ww
om

rsin

c g-le

w ww
s.c ture om

sing .nur

-l

es.c ctur e

ww
s.c ture om

ww
es.c ctur om

ur w.n

sin

tur -lec g

es.c

rsin

c g-le

ww
es.c ctur om

sin .nur

c g-le

w.n ww
es.c ctur om

ng ursi

-le

.nur ww w
om es.c tur
ww
om

sin

tur -lec g

es.c

g rsin

-le

-le sing r .nu Indication:w.nu w spontaneously breathing, with www w - To patient decreasing level of PaO2.
- In state of anxiety, without the need of high oxygen concentration om O2 flow up to 4 L/min om

lec ingrs

ur w.n

sin

tur -lec g

es.c

rsin

c g-le

s.c ture

ing Advantages: .nurs w ww

-l

es.c ctur e

ww
es.c ctur -le om

ur w.n

sin

c g-le

s.c ture

w
s.c ture om

si .nur ww

tur -lec g

es.c

om es.c tur -lec

-lec

es.c ctur -le

rsin
ww
om es.c tur

ur w.n

sin
ww
s.c ture om

ur w.n

sin
w
s.co ure t m

.nur ww

sin

rsin

- Safe and simple sin sin - Easy fixation. rsin .nu .nur .nur w w w - Facilitate verbal communication. ww ww ww - Possibility for performing mouth care. - Comfortable, allows patient to eat and drink om om om Disadvantage: es.c Cant deliver concentrations higher es.c es.c es.c ctur ctur ctur ctur -le -le -le -le than 40%; sing sing sing sing r ur ur .nur Cant bew.n in complete nasal obstruction. w.n w used w ww w w Mayw cause headaches or dry mucous membranes; can remove easily. Nursing care principle: facial om Avoid applying it too tightly, which can result in excess pressure on.com structures om s.c es.c as well as cannula occlusion.ures.c es tur t tur ture

c g-le

c g-le

c g-le

tur -lec g

es.c

grsin

lec

lec lec ingingurs Medium ConcentrationnFace Masks urs w.n w. ww ww

om es.c ctur
w.n ww
s.co ure ect m
w sing .nur -l

ww
om

w.n

lec ingurs

rsin

c g -l e

s.c ture

om
sing .nur w -le

ww
s.c ture om

lec ingurs

s.c ture

ww
om

si .nur w

tur -lec g

es.c

rsin

c g-le

w ww
s.c ture om

sing .nur

-l

es.c ctur e

ww
s.c ture om

ww
es.c ctur om

ur w.n

sin

tur -lec g

es.c

rsin

c g-le

ww

sin .nur

c g-le

w.n ww

ng ursi

-le

.nur ww w

sin

tur -lec g

es.c

om O2 flow rate must be at least s.l/min om 5 om es.c Amount of O2 received is dependent on the patients rate andtdepth.c breathing, e c es of es.c ctur ctur c ur ctur le -le -le -le Not possible tosing exactly how much O2 is beingsdelivered know ingsing sing r .nur .nur .nur Poor humidification ww ww ww w w w Disposable
s.c ture om
Fixed Concentration Masks Venturi .com om s es.c ur ure lect lect ngngursi ursi w.n w.n ww ww

Hudson / MC masks

rsin

c g-le

si .nur ww

tur -lec g

es.c

om es.c tur -lec

es.c ctur -le

om
-lec

s.c ture

om

es.c ctur -le

rsin
ww
om es.c tur

ur w.n

sin
ww
s.c ture om

ur w.n

sin
w
s.co ure t m

.nur ww

sin

rsin

c g-le

ww
om es.c tur

ur w.n

sin

c g-le

ww
s.c ture om

ur w.n

sin

c g-le

.nur ww w
om
.nur ww w

sin

tur -lec g

es.c

rsin

c g-le

ww
es.c ctur g-le om

sin .nur w

c g-le

ww
om es.c tur
ww

lec ings .nur

s.c ture

sin

tur -lec g

es.c

rsin

w ww

sin .nur

c g-le

sing .nur w

-l

om es.c r ectu
ww ur w.n

sin

tur -lec g

es.c

Fixed Concentration Masks om om .com Venturi es es.c es.c es.c r tur ctur ct recommended flow rate to achieveccorrect percentage of O2 ctur O2 has to be at minimumu -l e -le -le -le O2 flow from rsng l/min 4 i 15 sing sing sing r .nu .nur .nur O2 delivery up to 60% ww ww ww w w w

rsin

tur -lec g

es

Bernoulli principle port size of valve ensures the correct proportions of O2 and entrained air are mixed to obtain a fixed O2 concentration .com Able to increase flow rate without m .co altering percentage of O2 .com

es es es.c ctur ctur ctur -le -le -le Venturi mask sing sing sing r r Venturi mask mix a fixed flow of oxygen with anu but variable flow of air to w.nu .nur . high ww ww w w producew constant oxygen concentration. w a
tu -lec g
tu -lec g
tur -lec g

rsin

tu -lec g

Oxygen enters via jet (restricted opening) at high velocity, room air also enters and mixes with the oxygen at this site. The higher the velocity (smaller the opening), the om om .com room air is drawn. es more es.c es.c r r r

es.c

ww
es.c ctur om

ur w.n

sin

Reservoir Masks s .nur ww w

in

.nur ww w

sin

g rsin

-le

sing .nur w ww
om

-le

es.c ctur

om
u w.n lec ingrs

om es.c tur
ww ur w.n sin

tur -lec g

es.c

ww
es.c ctur e om

rsin

c g-le

s.c ture

Reservoir Masks ing-l Non-rebreath s .nur mask

w ww

ww
om

ur w.n

sin

c g-le

s.c ture

om
si .nur ww n

tur -lec g

es.c

w
s.c ture om

om es.c tur -lec

es.c ctur -le

-lec

es.c ctur -le

rsin
ww
om es.c tur

ur w.n

sin
ww
s.c ture om

ur w.n

sin
w
s.co ure t m

.nur ww

sin

rsin

c g-le

O2 delivered betweenec 85% l 60 lec ing-litres/min ing O2 flow must rs 15 u be urs w.n filled with O2 by at least 2/3ww.n applying to patient Bag ww be should w before

High FiO2 delivered because of reservoir which provides increased volume of O2

.nur ww w

sin

tur -lec g

es.c

rsin

c g-le

om es.c tur
ww sin .nur w

c g-le

s.c ture

om Tracheostomy tube
ww w lec ings .nur

s.c ture

om
.nur ww w sin

tur -lec g

es.c

rsin

es.c ctur g-le

om
w ww sin .nur c g-le

om es.c tur
ww

sing .nur w

-l

om es.c r ectu
ww
s.c ture om

ur w.n

sin

tur -lec g

es.c

rsin

c g -l e

s.c ture

om
sing .nur Indication:w ww -le

om es.c ctur
w.n ww

lec ingurs

- Failing to wean the patient from M.V. - When airway blocked and intubation is impossible. om When suspected edema of the larynx. om om es.c - When an intubation endangers .to the patient (cervical spine #).ures.c es c tur tur lect -lec -lec Advantage in g ing ingrs rs urs - No danger.inu w n damaging the vocal cord w.n ww ww - Ability to verbal communication. - Ability to perform an efficient mouth care program.

ww

si .nur w

tur -lec g

es.c

ww

ur w.n

sin

tur -lec g

es.c

rsin

c g-le

om es.c Disadvantage tur

-le - Risk for bleedingng-lec i and emphysema. sdamage in prolonged use. sing - Risk of tracheal .nur .nur ww ww - Riskw developing granulomas in operation incisions. of w
Increase risk of displaced canula in the first 24hr.

s.c ture

om

es.c ctur

om
.nur ww w sin

tur -lec g

es.c

g rsin

-le

es.c ctur

om
sing .nur w ww -le

om es.c CPAP mask ctur

ww u w.n

lec ingrs

om es.c tur
ww ur w.n sin

tur -lec g

es.c

rsin

c g-le

om es.c Advantages: tur

This system allows the spontaneously breathing patient to receive continuous positive airway pressure (CPAP) with or without an artificial airway. - Noninvasivelyrsingimproves arterial oxygenation u

es.c ctur e

om

w.n ww

ww

ur w.n

sin

c g-le

s.c ture

om

w
s.c ture om

si .nur ww

tur -lec g

es.c

om es.c tur -lec

es.c ctur -le

om
-lec

es.c ctur -le

rsin
ww
om es.c tur

ur w.n

sin
ww
s.c ture om

ur w.n

sin
w
s.co ure t m

.nur ww

sin

rsin

c g-le

- by increasing functional residual capacity; lec lec ing- avoid intubation; ing- Allows the nurs to patient urs w.patient to talk and cough withoutww.n - allowsw w the w interrupting positive pressure. Disadvantages

.nur ww w

sin

tur -lec g

es.c

om Requires a tight fit, which may.com discomfort; interferes with eatingm talking; s cause s.co and es.c heightened es.c ur ure ure ct ct ct ctur -le -le -le -le Risk of aspiration if the patient vomits. sing sing sing sing r ur .nur .nur Increased risk of pneumothorax, diminished cardiac output, and gastric distention;w.n ww ww w w w w
om es.c r
Risks of Oxygen Therapy om om es.c es.c tur tur -lec -lec sing sing - O2 toxicity: u .n r .nur w w ww - Very high levels lead to CNS toxicity and ww

rsin

tu -lec g

ww

ur w.n

sin

tur -lec g

es.c

seizures -mLower levels (FiO2 > 60%) and longer exposure (48hr): capillary damage, leak and o om om pulmonary fibrosis es.c es.c es.c es.c ctur ctur ctur ctur - PaO2 >150 can cause lretrolental fibroplasia -l e -e -le -le sing sing safely tolerated indefinitelyursing sing r - FiO2 35 to 40% can be .nur .n .nur

w ww Clinical manifestation of O2 Toxicity om om om es.c es.c es.c tur tur tur -lec -lec -lec g g - Restlessness, chestin s pain, dyspnea and cyanosis. ursing rsin .nur and vomiting w.n - Nausea, ww w anorexia ww

ww

ww

CO2 narcosis: - PaCO2 may increase severely to cause respiratory acidosis and coma. Nursing Alert om om com es.c Because hypoxemia stimulates es.c es.increase the es.c COPD, ctur ctur respiration in the pts with sever ctur ctur e e -le -le oxygen flow level sing-l rate may greatly raise the patient-l to a high sing sing blood oxygen level. At the ursing r r same time this nu suppress the respiratory drive, causing increase retention of CO2 andn . will .nur w. ww ww w w ww CO2 narcosis. So oxygen given with low concentration

ww

ur w.n

sin

tur -lec g

es.c

g rsin

-le

es.c ctur

om

Room Air is 50% humidified O2 is 0 % humidified om .com Dehydration of the respiratory .tract by O2 can cause epithelial damage m s.co es es c ur urcilia and damage to mucous glandsure Resulting in destruction t lect lecof lect inging- inspired gases ing Important to urs humidify rs urs

om com es.c Indications for Humidification tures. tur lec -lec ing ingurs urs w.n w.n ww ww

ww

ur w.n

sin

tur -lec g

es.c

w.n ww

ww

w.n

w
s.c ture om

si .nur ww

tur -lec g

es.c

om es.c tur -lec

es.c ctur -le

om
-lec

es.c ctur -le

rsin
ww
om es.c tur

ur w.n

sin
ww
s.c ture om

ur w.n

sin
w
s.co ure t m

.nur ww

sin

rsin

c g-le

O2 of at least 40%g-lec or above should be humidified lec in ing Cold / Hot nurs humdification water urs w. w.n Saline w w nebulisers can be used as alternative w w

.nur ww w
om
.nur ww w

sin

tur -lec g

es.c

rsin

c g-le

om es.c tur
ww sin .nur w

c g-le

s.c ture

om
w lec ings .nur

s.c ture

sin

tur -lec g

es.c

ww
om es.c tur
ww
om es.c ctur

rsin

es.c ctur g-le

om
w ww sin .nur c g-le

sing .nur w

-l

om es.c r ectu
ww
s.c ture om

ur w.n

sin

tur -lec g

es.c

rsin

c g -l e

s.c ture

om
sing .nur w -le

ww
s.c ture om

w.n ww
s.co ure ect m
w

lec ingurs

ww
om

si .nur w

tur -lec g

es.c

rsin

c g-le

w ww
s.c ture om

sing .nur

-l

ww
s.c ture om

sing .nur

-l

es.c ctur e

ww
es.c ctur om

ur w.n

sin

tur -lec g

es.c

rsin

c g-le

ww
es.c ctur om

sin .nur

c g-le

w.n ww
es.c ctur om

ng ursi

-le

.nur ww w
om es.c tur
ww
s.c ture om

sin

tur -lec g

es.c

g rsin

-le

sing .nur w ww
om

-le

ww
es.c ctur e om

u w.n

lec ingrs

ur w.n

sin

tur -lec g

es.c

rsin

c g-le

s.c ture

sing .nur w ww

-l

ww
es.c ctur -le om

ur w.n

sin

c g-le

w
s.c ture om

si .nur ww

tur -lec g

es.c

om es.c tur -lec

-lec

es.c ctur -le