Na Ii Ppt Module 2


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Na Ii Ppt Module 2

  1. 2. Module Title: Oxygen Therapy-Set Up and Monitoring Flow Rate
  2. 3. Oxygen Therapy <ul><li>Oxygen is necessary for life. Oxygen is obtained through inhalation unless a disease process prevents enough oxygen from feeding the body’s tissues. </li></ul><ul><li>Every cell in the human body produces the waste product: carbon dioxide (CO2) </li></ul><ul><li>CO2 is transported via venous blood to the lungs where it is eliminated through exhaling. </li></ul><ul><li>Death results if CO2 levels become too high due to lack of elimination </li></ul><ul><li>You will care for many patients who have problems related to the respiratory system. </li></ul>
  3. 4. Oxygen Therapy <ul><li>Signs and Symptoms of Decreased Oxygenation : </li></ul><ul><li>Changes in skin color-dusky, pale, blue or gray </li></ul><ul><li>Changes in color of lips, nail beds, mucous membranes, lining of the mouth </li></ul><ul><li>Cool, clammy skin </li></ul><ul><li>Slow, rapid or irregular breathing </li></ul><ul><li>Shortness of Breath or dyspnea (difficult/labored breathing) </li></ul><ul><li>Noisy breathing </li></ul><ul><li>Gasping for breath </li></ul><ul><li>Changes in mental status- restlessness, confusion, drowsiness </li></ul><ul><li>Tachycardia </li></ul>
  4. 5. Oxygen Therapy <ul><li>Oxygen is a prescription item that requires a doctor’s order </li></ul><ul><li>Doctor will specify method of administration and amount of flow </li></ul><ul><li>NA II’s/PCT’s are not permitted to start, stop or change the flow rate of oxygen unless you are trained in the procedure, permitted to do it in your facility and have an order to make the change </li></ul>
  5. 7. Oxygen Therapy <ul><li>3 Main Oxygen Sources </li></ul><ul><li>Wall Oxygen </li></ul><ul><li>Cylinder Oxygen </li></ul><ul><li>Oxygen Concentrator </li></ul>
  6. 8. Oxygen Therapy <ul><li>Wall Oxygen- </li></ul><ul><li>In the hospital setting, oxygen is pumped directly into the patient’s room through a wall outlet </li></ul><ul><li>A flow meter is plugged into the outlet to control the amount of O2 administered to the patient </li></ul><ul><li>After attaching a meter to the outlet, turn the knob to the right (clockwise) to start the flow of O2 </li></ul>
  7. 9. Oxygen Therapy <ul><li>O2 flow rate is measured in liters per minute (l/m) </li></ul><ul><li>Green is the standard label color coding for O2 </li></ul><ul><li>May require a humidifier bottle to moisten the oxygen before it enters the patient. This is done to prevent drying out of the sinuses and nasal passages </li></ul>
  8. 10. Oxygen Therapy <ul><li>Humidifier Bottles </li></ul><ul><li>Used with high flow rates of O2 </li></ul><ul><li>Moisten the membranes of the nose, sinuses, throat, and lungs </li></ul><ul><li>When operating properly, the water should be bubbling </li></ul>
  9. 11. Oxygen Therapy <ul><li>Can be prefilled/disposable or refillable </li></ul><ul><li>Must use distilled water in refillable bottles to prevent Legionnaires disease </li></ul><ul><li>Are not required for flow rates below 5 liters but follow your facility policy for use of humidifier bottles </li></ul><ul><li>Bottles should be changed/refilled per facility policy and initialed and dated at the time of the change/refill </li></ul>
  10. 12. Oxygen Therapy <ul><li>Cylinder Oxygen: </li></ul><ul><li>Portable cylinders are used for transporting patients from one area to another, for emergencies and for other areas without piped in O2. </li></ul><ul><li>There are various sizes of portable oxygen tanks. Each tanks requires a specific type of gauge </li></ul><ul><li>Gauges show how much oxygen is in the tank and how much pressure the oxygen is under </li></ul><ul><li>Portable tanks are considered empty when the pressure reaches 500 pounds. </li></ul><ul><li>How long a tank will last depends on the rate of O2 flow </li></ul><ul><li>Portable tanks should always be secured in a base or chained to a wall or carrier. Cylinders can explode when dropped. </li></ul>
  11. 13. Oxygen Therapy <ul><li>Oxygen Concentrators- </li></ul><ul><li>Used mainly in long-term care facilities </li></ul><ul><li>Do NOT contain oxygen but convert room air to oxygen then deliver it to the patient </li></ul><ul><li>Concentrators are portable and also noisy, hot and require electricity to run </li></ul><ul><li>Concentrators can only handle small flow rates of less than 5 l/m </li></ul><ul><li>This is the most economical method of O2 delivery </li></ul>
  12. 16. Oxygen Therapy <ul><li>Delivery methods </li></ul><ul><li>Nasal Cannula </li></ul><ul><li>Face Mask </li></ul><ul><li>Trachea Collar </li></ul>
  13. 17. Oxygen Therapy <ul><li>Nasal Cannula- </li></ul><ul><li>Is a small tube with two slightly curved prongs that fit into the patient’s nostrils </li></ul><ul><li>The curve should point inward when inserted into the nose </li></ul><ul><li>Used for low liter flows </li></ul><ul><li>Available in adult and pediatric sizes </li></ul><ul><li>The type of administration set will be decided by the doctor based on patient needs </li></ul>
  14. 18. Oxygen Therapy <ul><li>Face Masks- </li></ul><ul><li>Simple Mask- fits over the patient’s nose, mouth and chin </li></ul><ul><li>Small tube connects the mask to the O2 source </li></ul><ul><li>Used with high flow rates and for mouth breathers </li></ul><ul><li>Should NOT be used for flow rates under 5 liters because it may cause re-breathing of exhaled CO2 and have a smothering effect </li></ul><ul><li>Special masks are used for tracheostomy patients </li></ul>
  15. 19. Oxygen Therapy <ul><li>Nonrebreathing Mask- is a modification of the simple mask. </li></ul><ul><li>Use for patients with sever hypoxemia (insufficient oxygen in the blood) </li></ul><ul><li>Has one-way plastic flaps on the sides of the mask that allow the exhalations to escape but outside air cannot enter </li></ul><ul><li>A reservoir bag is connected to the bottom of the mask and should be inflated at all times and should not collapse more than halfway during inspirations </li></ul><ul><li>This type of mask increases the amount of O2 delivered to the patient </li></ul>
  16. 20. Oxygen Therapy <ul><li>Air Entrainment Mask/ Venturi Mask- </li></ul><ul><li>Similar to a simple mask but has a large plastic tube at the bottom of the mask where it connects to the O2 source </li></ul><ul><li>This mask mixes oxygen with room air to obtain the percentage of O2 ordered by the physician </li></ul><ul><li>The settings on the mask are changed according to the physician’s order </li></ul><ul><li>Do not allow the patient to adjust the settings </li></ul>
  17. 24. Oxygen Therapy <ul><li>Safety Guidelines for Oxygen Use </li></ul><ul><li>Before initiating Oxygen check room for safety </li></ul><ul><li>Post “Oxygen in Use” signs over the bed and on the door of the room OR according to facility policy </li></ul><ul><li>Avoid sparks or static electricity which start a fire </li></ul><ul><li>Never use flammable liquids such as nail polish remover, adhesive tape remover, vaseline or electrical equipment such as blow dryers, shavers, fans radio or TV and even call bells before checking with the RN </li></ul>
  18. 25. Oxygen Safety <ul><li>Smoking is not allowed in the room </li></ul><ul><li>Learn how to turn off Oxygen in case of emergency </li></ul><ul><li>Respond to all alarms and strange noises immediately </li></ul><ul><li>Raise the head of the bed to ease breathing </li></ul>