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NURS1213 > Oxygen therapy > Flashcards

Oxygen therapy Flashcards

1
Q

what are the three indications for insertion of an artificial airway (oral airway)

A
  • Decreased level of consciousness
  • airway obstruction
  • to help in the removal of tracheobronchial secretions
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2
Q

What is the purpose of an oral airway?

A

• Prevents obstruction of the trachea by displacement of the tongue into the oropharynx. Maintains the tongue in normal position.

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3
Q

How do you measure correct size for oral airway?

A

Measuring distance from the corner of the mouth to angle of the jaw just below the ear.

  • Length is equal to distance from the flange of the airway to tip
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4
Q

What happens when the airway is too small?

A

Tongue is not held in anterior portion of the mouth

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5
Q

What happens when airway is too big?

A

May force tongue towards the epiglottis and obstruct airway

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6
Q

What is the goal of oxygen therapy?

A

• receive an optimal arterial oxygen tension by giving lowest possible amount of effective dose of oxygen to avoid toxicity

  • used in variety of settings to relieve or prevent tissue hypoxia
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7
Q

Is oxygen considered a medication?

A

yes, treat it like a drug

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8
Q

What are possible side effects of oxygen?

A

atelectasis or oxygen toxicity

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9
Q

What does a physician’s order for oxygen therapy include?

A
  • O2 flow rate (FiO2)

Or

  • O2 therapy protocol for O2 titration
  • order may also include: specific O2 saturation goal (i.e., >90%); delivery system required; and when it is to be administered (e.g. continuous, with exercise, nocturnal).
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10
Q

What are some reasons why we would use supplemental oxygen therapy?

A
  • Decreases in oxygen carrying capacity =low levels of hemoglobin (anemia)
  • Decreased inspired O2 concentration (obstruction, hypovolemia)
  • Increased metabolic rate = increased demands for O2
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11
Q

What is SpO2

A

Peripheral capillary oxygen saturation

  • Estimated amount of oxygen in blood being bound/carried by percentage of oxygenated hemoglobin compared to total amount of hemoglobin
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12
Q

What is FiO2

A

concentration of oxygen that person inhales

  • Devices we use and how people breath can impact FiO2
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13
Q

what are the 10 rights of medication administration?

A
  1. The right medication
  2. The right dose
  3. The right patient
  4. The right route
  5. The right time and frequency
  6. The right documentation
  7. The right reason
  8. The right to refuse
  9. The right patient education
  10. The right evaluation
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14
Q

What are the normal levels of SpO2 for average person vs COPD

A

Normal: 92-98%

COPD: 88-92%

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15
Q

Does oxygen require an order?

A

yes

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16
Q

What do you have to do before transporting patient receiving oxygen?

A

When it is necessary to transport a patient receiving oxygen therapy at flow rates greater then 8LPM to achieve an O2 concentration (FiO2) of greater than 40%: consultation with a Registered Respiratory Therapist (RRT) to determine stability for transport

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17
Q

Are oxygen therapy devices one time use?

A

yes

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18
Q

Can you administer O2 in an emergency situation?

A

In an emergency situation (such as signs of acute respiratory distress), an RN, LPN or Registered Respiratory Therapist may initiate oxygen therapy without a physician’s order. A physician must be notified immediately.

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19
Q

List some safety measures to ensure are in place when administering oxygen

A
  • Inform patient, visitors, roommates and all personnel that smoking is not permitted in areas where oxygen is in use
  • Ensure all electrical equipment in room is functioning corrected and properly grounded. An electric spark in presence of oxygen can start fire
  • Locate closest fire extinguisher
  • Know fire procedures and evacuation route for area
  • Check oxygen level of portable tanks before transporting patient to ensure enough oxygen in tank exist to complete transport
  • Oxygen cylinders are secured to prevent tipping/falling
20
Q

what are the concentrations delivered and flow rate for a low flow nasal cannula?

A
  • 24-28% concentration = 1-2L/min flow
  • 32-36% concentration = 3-4L/min
  • 40-44% concentration = 5-6L/min
21
Q

what are the pros of low flow nasal cannula?

A
  • It’s convenient and easy to set up. Can deliver both high and low Fi with variable Fo
  • comfortable
22
Q

What are the cons of low flow nasal cannula?

A
  • Higher than 4 L / min can dry the mucosa (humidification is needed)
  • Skin breakdown over ears and in nares from too tight application
  • Easily dislodged
23
Q

what are the concentrations delivered and flow rate for a high flow nasal cannula?

A
  • 5L = 50%
  • 10L=62%
  • 15L= 80%
24
Q

What are the pros for high flow nasal cannula?

A
  • For patients who cannot tolerate a face mask for prolonged periods
25
Q

What are the cons of high flow nasal cannula?

A
  • Uses special high-flow tubing only available through Respiratory Therapy or on Crash Cart
  • May be drying to mucous membranes
  • Skin breakdown over ears
26
Q

what are the concentrations delivered and flow rate for a simple face mask?

A
  • 5-6L = 40%
  • 6-7L= 50%
  • 7-8L= 60%
27
Q

What are the pros of simple face mask?

A
  • Higher Fi is possible because mask acts as additional oxygen reservoir
  • Can attach to a nebulizer to deliver medications and humidity
28
Q

What are cons of simple face mask?

A
  • Patient is unable to eat, speech may be muffled
  • Flow must be > 5 L / min to avoid dangerous CO2 build up, rebreathing of CO2 will occur
  • For short term therapy (<12 hrs)
29
Q

what are the concentrations delivered and flow rate for a venturi mask?

A 
24% - blue
28% - white
31% - orange
35% - yellow
40% - red
60% - green
  • flow is as per color-coded value (4-12L)
30
Q

What are pros for venturi mask?

A
  • Mask entrains room air to achieve a consistent and precise oxygen concentration
  • Helpful for patients with COPD who require low, constant oxygen concentrations
31
Q

What are cons for venturi masks?

A
  • Hot and confining
  • For short term therapy
  • Interferes with communication and eating
32
Q

what are the concentrations delivered and flow rate for a face tent mask?

A

10-15L

  • 40%
33
Q

What are pros for face tent mask?

A

For patients with facial trauma or claustrophobic

34
Q

what are the concentrations delivered and flow rate for a partial rebreathing mask?

A

10L

40-70%

35
Q

What are the characteristics with partial rebreathing mask?

A
  • Reservoir bag must remain inflated
  • No one way valve between mask and bag
  • For severe/acute distress
36
Q

what are the concentrations delivered and flow rate for a non-rebreathing mask?

A

10L

60-80%

37
Q

What are the characteristics of a non-rebreathing mask?

A
  • > 12 L will cause “whistle”
  • Reservoir bag must remain inflated
  • For severe/acute distress
  • 3 valves – one each side of mask, one way valve prevent CO2 from entering reservoir
  • Closed system, so if no O2 given (runs out), patient can suffocate
38
Q

What is the difference between low flow and high flow devices?

A

low flow:

  • Provide oxygen in concentrations that vary with patient’s respiratory pattern
  • Also known as variable performance – as the FiO2 fluctuates based on breathing pattern

High Flow:

  • deliver oxygen rates above normal respiratory flow rate and therefore provide a fixed FiO2 (fraction of inspired air) regardless of patient breathing pattern and inspiratory flow
  • Aka fixed performance- specific fiO2 delivered because device exceeds the flow the patient breathes in
39
Q

What are some examples of low flow devices?

A
  • Nasal cannulas,
  • simple face masks
  • reservoir masks
  • non-rebreathing mask
  • face tent mask
40
Q

What are some examples of high flow devices?

A
  • Venturi mask

- large volume or high flow cold neb devices

41
Q

what is the purpose of a higher volume of oxygen reservoir?

A

the higher the volume of oxygen reservoir, the more oxygen the patient has to draw from, which provides a higher FiO2 to the patient

42
Q

what is humidified oxygen?

A

the respiratory therapist will attach the vessel containing sterile water directly to the oxygen flow meter

43
Q

What is a large volume nebulizer (humidifers) used for?

A

Large volume nebulizers (humidifiers) are used for patients requiring higher flow oxygen. An aerosol mask is used, with larger bore, aerosol tubing.

44
Q

What are some nursing considerations for administration of humidified oxygen?

A
  • normal to see mist flowing from the patients mask
  • Because the tubing is larger, water tends to build up in the dependent loop.
  • Do not drain excess water back into the nebulizer; detach the aerosol tubing and empty in to another receptacle (cup).
  • A t-piece and “tusks” may be added to an aerosol mask to prevent the client’s inhalation of room air through the side holes in the mask
  • Do not transport patients with humidified oxygen as there is a risk that spilling of the sterile water into the oxygen tubing could lead to aspiration
45
Q

what is nebulization?

A

Adding moisture or medication to inspired air by mixing particles with air and moisture improves clearance of pulmonary secretions

46
Q

What are the characteristics of a fixed device cold nebulizer?

A
  • High flow device
  • Can provide 28, 30, 35, 40, 45, 50, 75, 100% based on dial
  • 10-15L/min
  • Not recommended for patients that require high oxygen demands (fiO2 over 40)
  • Not used for transport
47
Q

What are the characteristics of fixed device high flow cold nebulizer?

A
  • Provides fixed oxygen concentration
  • 60,65,70,75% of O2
  • Flow rate: 15L/min? all the way to the top

NURS1213 (11 decks)

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