Topic 15 - Oxygenation

Pros of face masks

- Achieve higher o2 concentration than nasal cannula

Sources of oxygen in medical setting

- Hospital wall panel - Portable oxygen cylinder

Pros of nasal cannula

- Patient are able to eat, drink and speak freely - Lightweight and generally comfortable - can be used at very low flow rates for children

Cons of nasal cannula

- drying to the nose - not ideal for mouth breathers

Types of oxygen delivery system

-Nasal cannula/prong - Face mask: Simple mask/ partial rebreather mask/ nonrebreather mask/ venturi mask

Flow rate delivery venturi mask mask is capable of

24-55%

Oxygen concentration delivery simple mask is capable of

35-60%

Oxygen rate delivery venturi mask is capable of

4-10L/min

Flow rate delivery simple mask is capable of

6-10L/min

Flow rate delivery nonrebreather mask mask is capable of

6-15L/min

Flow rate delivery partial rebreather mask is capable of

6-15L/min

Oxygen rate delivery nonrebreather mask is capable of

60-100%

Oxygen concentration delivery partial rebreather mask is capable of

70-90%

Percentage range of o2 saturation that could indicate significant oxygenation problems

80-90%

Hypoventilation

A decreased rate of air movement into the lungs

Hyperventilation

An increased rate and depth of ventilation above the body's normal metabolic requirements

More likely to occur when face mask is in place

Aspiration of vomitus

The brain is sensitive to hypoxia and will sustain irreversible brain damage after how many minutes? a. 2 to 4 minutes b. 4 to 6 minutes c. 6 to 8 minutes d. 8 to 10 minutes

B

Auditory observation of patients with impaired gas exchanged

Breathing is accompanied with *crackling* or *wheezing* sound

Types of patients that experience problems with oxygenation

COPD, asthma, trauma, allergic reaction, chronic illness, post-op, overdose opioids, smoker

A patient who complains of difficulty breathing should be placed in which of the following positions? a. Prone position b. Lateral position c. Supine position d. Fowler's position

D

Mr. Parks has chronic obstructive pulmonary disease. His nurse has taught him pursed-lip breathing, which helps him in which of the following ways? a. Increases carbon dioxide, which stimulates breathing b. Teaches him to prolong inspiration and shorten expiration c. Helps liquefy his secretions d. Decreases the amount of air trapping and resistance

D

True or False: It is okay to drag or slide cylinders, especially for short distances

False

True or False: Always attempt to catch a falling oxygen cylinder

False

Contraindication to nasal cannula

If patient tends to breath orally

Hypoxia

Inadequate amount of oxygen in the cells

Altelectasis

Incomplete lung expansion or lung collapse

Hypercarbia

Increased carbon dioxide level in the bloodstream.

Diffusion

Movement of oxygen and carbon dioxide between the air and the blood

Identify which mask is this: Probably the most commonly used respiratory aid, this consists of a disposable, plastic device with two protruding prongs for insertion into the nostrils; it is connected to an oxygen source with a humidifier and a flow meter.

Nasal cannula

Oxygen delivery system that should be used to deliver < 6L/min of oxygen

Nasal cannula

Identify which mask is this: Produces the highest concentration of oxygen with a mask; contains two oneway valves that prevent conservation of exhaled air, which escapes through side vents

Nonrebreather mask

Mask that delivers the highest percentage of oxygen? What percentage?

Nonrebreather mask. 60-100%

Identify which mask is this: This mask is equipped with a reservoir bag for the collection of the first part of the patient's exhaled air. The air is mixed with 100% oxygen for the next inhalation.

Partial rebreather mask

Specific group of patients that *cannot* receive too much oxygen

Patients with COPD. Their lungs are used to having lower concentrations of o2 as their sacs have been damaged or destroyed.

Perfusion

Process in which the oxygenated capillary blood passes through tissu

What is oxygen treatment regarded as?

Regarded as medication. Must be ordered by healthcare professional in written order

Purpose of pursed-lip breather

Results in increase use of intercostal muscle for breathing, leading to decrease respiration rate, improving saturation levels

Best bed position to place patients with impaired gas exchange in

Semi-fowler's position

Identify which mask is this: Connects to oxygen tubing, a humidifier, and flow meter and uses a delivery flow rate greater than 5 liters/minute; it should be comfortably snug over face but not tight; it has vents in sides to allow room air to leak in at many places, diluting the source oxygen

Simple face mask

Purpose of oxygenation

To increase the amount of oxygen transported in the blood

Identify which mask is this: This mask delivers the most precise concentration of oxygen and has a large tube with an oxygen inlet. As the tube narrows, pressure drops, causing air to be sucked in through the side ports

Venturi mask

When should oxygen by humidified?

When the delivery exceed 4L/min (does not apply to non-rebreather mask)

Incentive spirometer

a resistive breathing device that helps patients exercise their breathing muscles

Cyanosis

bluish discoloration of the skin, often caused by low oxygen

Purpose of performing controlled coughing

helps clear sputum & decrease coughing spasms

Unit of measurement for oxygen

litres/minute