Clinical fundamental of nursing

Oxygen(O2) therapy

Prepared by : Lana badawi

Instructed by : Mustafa sholi

Ibn Sina College

Oxygen(O2) therapy

Outline and objectives:

1. Introduction and definition

2. Indication

3. O2 delivery system

4. Advantages and disadvantages

5. Side effects

6. Nursing action

Introduction

Oxygen is an odorless, tasteless, colorless, and transparent gas .That is slightly heavier than air. Because oxygen supports combustion, there is always danger of fire, when oxygen is being used, oxygen can be dispensed from a cylinder, piped in system, liquid oxygen reservoir or oxygen concentrated

lower Airway

Gas exchange

Definition

What is the O2 therapy ???

Providing a adequate oxygen in the blood , while decreasing the work of breathing and reducing stress in the myocardium

Indication to use Oxygen

Main condition

Hypoxia

Hypoxemia

Mechanisms of Hypoxia

Aerobic Metabolism requires:

O2 utilization

O2 Delivery O2 Utilization

O2 Delivery

Shift from aerobic to anaerobic metabolism

Increase Lactic acid

Cell Death

Indication

Short term indication 1. Acute hypoxemia

2. Hypotension

3. Low COP

4. Respiratory distress

5. Angina

6. Dyspnea

7. MI (myocardial infarction)

8. Premature babies

Indication

Long term indication:1. COPD (Chronic Obstructive Pulmonary Disease)

2. Cystic Fibrosis

3. Late stage Heart failure

4. Sleep related breathing disorder

O2 delivery system

Oxygen may be administered by nasal cannula, various types of masks, head box, tent, catheter, T-piece, Tracheostomy collar . It also applied directly to the endotracheal tube via mechanical ventilator .The method selected depends on the required concentration of oxygen.

Nasal cannula

Nasal cannula

Suggested flow rate 1_6 liter / min O2

Provide 24% _44%

Advantages:

Light weight ,comfortable ,inexpensive , continuous use with meals and activities

Disadvantages:

Nasal mucosa , drying , variable fio2

Masks

Masks

Suggested flow rate 5_12 L/min

Provide 40%_100%

Advantages:

Simple to use , inexpensive , High O2 concentration , Good humidity , accurate fio2 (depend on mask type)

Disadvantages:

must remove to feeding , Poor fitting , Uncomfortable

Catheter

Catheter

Suggested flow rate 1_6 L/min

Provide 23%_40%

Advantages:

Inexpensive

Disadvantages:

Variable fio2,requires frequent change ,gastric distension can occur

Head box or tent

Head box or tent

Suggested flow rate 8_10 L/min

Provide 30%_100%

Advantages:

Fairly accurate fio2

Disadvantages:

Bulky , compression

T-piece

T-piece

Suggested flow rate 8_10 L/min

Provide 30%_100%

Advantages:

Good humidity , accurate fio2

Disadvantages:

Heavy with tubing

Tracheostomy collar

Tracheostomy collar

Suggested flow rate 8_10 L/min Provide 30%_100%

Advantages:

Good humidity , accurate fio2

Disadvantages:

uncomfortable some

ETT (endotracheal tube) with mechanical ventilator

Mechanical ventilator Can control:- Tidal volume.

- Rate

- Fraction of inspired oxygen(FIO2)

- Peak airway inspiratory pressure (PIP)

- Continuous positive airway pressure (CPAP)

- positive end expiratory pressure (PEEP)

Complication of ETT and mechanical ventilator

1- Air way obstruction(thickened secretions, mechanical problems with artificial airway or ventilator circulatory.

2- Tracheal damage 3- pulmonary infection 4- Barotrauma (pneumothorax) 5-Decrease cardiac output 6- Other GI complication

O2 therapy side effects

Oxygen Toxicity.Oxygen Paradox.Depression of Respiratory Center.Oxygen Poisoning.Complications in newborns

Nursing action :

1- Determined the current vital signs ,level of consciousness, and most recent ABG’s

2-   Check the vital signs 3-   Assess risk for co2 retention with o2

administration 4-   Make sure that the humidifier that is filled to the

appropriate mark 5-   Set the flow rate at prescribed liter per minute . 6-   Feel to determine if oxygen is flowing

Nursing action:

7- Determine patient comfort with oxygen use .

8- Remove mucus or saliva from the o2 device.

9- Monitor closely to ensure an accurate floe arte for specific Fio2

ANY QUESTION ????