Chapter 26: assisting with oxygen

How do you promote safety & comfort with deep breathing & coughing exercises?

-Encourage them to cover the nose & mouth when coughing or sneezing. -use tissues to contain respiratory secretions. -dispose of tissue in the nearest waste container after use. -wash his or her hands after coughing or contact with respiratory secretions. -make sure you wear gloves when splinting their incision.

How do you promote safety & comfort with oxygen sources?

-Never tamper with the equipment because liquid oxygen freezes the skin. Follow agency procedures & manufacturers instructions. -always check the O2 level when you are with or near persons using these oxygen sources. Report a low O2 level at once.

What food is involved in a high iron diet?

Green leafy vegetables

What is Orthopnea?

Breathing deeply & comfortably only when sitting.

What is hyperventilation?

Breathing is rapid, and deeper than normal.

What is Hypoventilation?

Breathing is slow, shallow, and sometimes irregular.

What is deep breathing & coughing exercises used for & when?

Deep breathing & coughing exercises promote oxygenation. They're done after surgery or injury or during bedrest. Usually done every 1-2 hours while the person is awake.

Your patient is on a high fiber & residue restricted diet and is unsure why. What is the reason this diet is used?

Diarrhea.

What is dyspnea?

Difficulty, labored, or painful breathing.

What are reasons a patient would be on a high protein diet?

For burns, high fever, and infection.

What is oxygen concentration?

Is the amount (percent) of hemoglobin containing O2 (oxygen).

What is a flow rate?

Is the amount of oxygen given

What is a simple face mask?

It is a device for giving oxygen. It covers the nose & mouth. The mask has small holes on the sides.

What is the flow rate measured in?

It is measured in liters per minute (L/min)

What is apnea?

Lack or absence of breathing.

What is hypoxia?

Means that cells do not have enough oxygen.

What is the correct order for advancing a diet for a postoperative patient?

NPO, clear liquid diet, full liquid diet, mechanical soft diet, & a regular diet.

What materials affect measurement with oxygen concentration?

Nail polish, fake nails, blood pressure cuffs, & movements. Remove nail polish or use another site, & don't use a finger site if the person has fake nails.

What is a wall outlet?

O2 is piped into each persons unit

What is oxygen?

Oxygen is a gas that has no taste, odor, or color.

What is a nasal cannula?

Prongs are inserted into the nostrils. A band goes behind the ears & under the chin to keep the device in place. -it allows eating & drinking.

What is tachypnea?

Rapid breathing. Respirations are more than 20 per minute.

What is cheyne-stokes respirations?

Resoirations gradually increase in rate & depth and then become shallow & slow. Breathing may stop for 10-20 seconds.

What are early signs of hypoxia?

Restlessness, dizziness, & disorientation.

What are the signs & symptoms of hypoxia?

Restlessness, dizziness, confusion & disorientation, behavior & personality changes, problems concentrating & following directions, anxiety & apprehension, fatigue, agitation, pulse rate increased, respirations increased rate & depth, sitting position often leaning forward, cyanosis, dyspnea, abnormal breathing patters, shortness of breath, cough, sputum, noisy respirations, chest pain, & positions.

In which position is breathing usually easier?

Semi- fowlers & fowlers position.

What is bradypnea?

Slow breathing. Respirations are fewer than 12 per minute.

How many liters of oxygen does the doctor order?

The doctor orders 1-15 liters if 02 per minute.

What is an oxygen concentrator?

The machine removes O2 from the air. A power source is needed. A portable oxygen tank is needed for power failures & mobility.

Who gives oxygen to patients?

The nurse & respiratory therapist start & maintain oxygen therapy.

Who sets the flow rates with a flowmeter?

The nurse or respiratory therapist

What is an oxygen tank?

The oxygen take is places at the bedside. Small tanks are used for emergencies & transfers. A gauge tells how much O2 is left.

Where is the sensor attatched?

To a finger, toe, earlobe, nose, or forehead.

What is kussmaul respirations?

Very deep and rapid respirations.

What can't you do when assisting with oxygen?

You do not give oxygen. You do not adjust the flow rate unless allowed by your state or agency.

What's your job when assisting with oxygen therapy?

You help provide self care. You do not give oxygen!

What is the normal range of oxygen concentration?

95% to 100%

What type of person will you see with Kussmauls respirations?

A person in a diabetic coma.

What type of person will you see with cheyne-stokes respirations?

A person near death

What type of person will you see with bradypnea?

A person with a drug overdose

What type of person will you see with hyperventilation?

A person with asthma or anxiety.

What type of person will you see with apnea?

A person with cardiac arrest

What type of person will you see with Orthopnea?

A person with emphysema

What type of person will you see with dyspnea?

A person with heart disease or anxiety.

What type of person will you see with hypoventilation?

A person with lung disorders

What type of person will you see with tachypnea?

A person with pain, fever, or involved in exercise.

What is a liquid oxygen system?

A portable unit is filled from a stationary unit. The portable unit has enough O2 for about 8 hours. A dial shows the amount of O2 in the unit. The portable unit is worn over the shoulder.

What is the orthopneic position?

A position where you're sitting up & leaning over a table to breathe.

What is your job when assisting with oxygen & their flow rate?

Always check the flow rate. Tell the nurse at once if it is too high or too low.

What sensor sites should you avoid?

Avoid swollen sites & sites with skin breaks.

What are the rules for oxygen safety?

-do not remove the oxygen device. -make sure the oxygen device is secure but not tight. -check for signs of irritation from the device (behind the ears, under the nose, around the face, cheekbones). -keep the face clean & dry when the mask is used. -do not shut off the oxygen flow (Only when there is a fire). -do not adjust the flow rate -tell nurse if flow rate is too high or slow. -tell the nurse if the humidifier is not bubbling. -maintain an adequate water level in humidifier -secure tubing in place (tape or pin in their garment). -make sure their are no kinks. -make sure they don't lie on the tubing -make sure oxygen tank is secure in it's holder -report signs/symptoms of hypoxia, respiratory distress, abnormal breathing patterns. -give oral hygiene every 2 hours. -make sure oxygen device is clean & free of mucus.

How do you promote safety & comfort with pulse oximetry?

-observe for signs & symptoms of hypoxia & altered respiratory system function. -a clip on sensor feels like a clothes pin. It should not hurt/cause discomfort. Ask the person to tell you at once if it cause pain, discomfort, or too much pressure -change the sensor site as directed by the nurse.

What terms may agencies use for oxygen concentrations?

-pulse oximetry or pulse ox -O2 saturation or O2 sat -SpO2 (saturation of peripheral oxygen)

What observations should you report/record with pulse oximetry?

-the date & time -the SpO2 & display pulse rate -apical or radial pulse rate -what the person was doing at the time -oxygen flow rate & the decide used -reason for the measurement:routine, continuous , monitoring, or condition change -an SpO2 below the alarm limit (usually 95%) -a pulse rate above or below the alarm limit

What are the DG for pulse oximetry?

-what site to use -how to use the equipment -what sensor to use -what type of tape to use -the persons normal range of SpO2 -alarm limits for SpO2 & pulse rate -when to do the measurements -what pulse site to use:apical or radial -how often to check the sensor sure (usually every 2 hours)

What are the DG for deep breathing & coughing exercises?

-when to do them & how often. -how many deep breaths & coughs the person needs to do. -report/record: the number of deep breaths & coughs. How the person tolerated the procedure. -when to report observations. -what patient or resident concerns to report at once.