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