nursing care plan for oxygen therapy

Assess the drainage on the dressing and the site. Check that dentures are removed and that there are no loose teeth before inserting the airway. Sign in or Register a new account to join the discussion. Respiratory #1. Citation: Olive S (2016) Practical procedures: oxygen therapy. They should be snug enough to prevent slippage but loose enough to allow circulation. Gather the needed equipment or a prepackaged kit. When used as a medical treatment, oxygen is regarded as a drug and must be prescribed. In healthy patients, a cough begins with. Reduce exposure to noxious fumes at home and at work. Because the tube is a direct opening into the lower respiratory tract, all the protective mechanisms of the upper airways have been bypassed. SaO2 via pulse oxygen, via 100% associated with inadequate delivery of oximetry is 90 – 100%. If you are changing the tapes that anchor the tube (usually done every 48 hours or more often if soiled), have another nurse help you keep the tube secure while changing them. Endotracheal tubes (ET) are long (240 to 360 mm in length) and 5 to 10 mm in internal diameter. Check the tension on the ties frequently to make sure that they are not too tight. Instruct the patient to purse his or her lips as if to whistle with lips slightly open. Low concentrations. Oxygen canisters and cylinders can pose a physical hazard. For those at risk of carbon dioxide retention (hypercapnia), a target of 88-92% ensures safe levels of oxygenation and minimises risk of respiratory acidosis. Basic Nursing Interventions• Airway Maintenance: • Facilitate effective coughing • Suctioning airways … Discard the suction catheter. Be calm and reassuring because the patient may be concerned about choking and being unable to communicate. Assess ability to expel secretions and/or auscultate the. Individuals with COPD may become hypoxic during increased activity and require oxygen therapy to prevent hypoxemia, which increases the risk for exacerbations of the COPD. Usually 1-6 L/min. Support legislation to control and eliminate pollution. You may use it if you have a disease that makes it hard to breathe, such as COPD, pulmonary fibrosis (scarring of the lungs), or heart failure. Flow rates above 4L/min can cause considerable drying of nasal mucosa and are more difficult to tolerate. In 2008, the British Thoracic Society produced guidelines for its use with acutely unwell adult patients (O’Driscoll et al, 2008). If the patient requires more suctioning, wait at least 2 minutes before performing it again. The tube should be slightly wider than the patient’s nares. The most important part of the care plan is the content, as that is the foundation on which you will base your care. This article outlines when oxygen therapy should be used and the procedures to follow. If there are superficial secretions, suction them first before manually inflating the lungs. Assess the patient’s breath sounds and breathing patterns. Repeat for three breaths and rest for 1 minute. Hold the tracheostomy tube with one hand to keep it from moving (which could stimulate coughing) and use the other hand to gently clean around the tube with sterile saline (or half-strength saline and peroxide depending on the institution’s guidelines). Treatments are required to maintain and enhance oxygenation. The FiO2 achieved varies with the rate and depth of breathing and, therefore, nasal cannulae should not be used in patients with unstable type 2 respiratory failure. 1. Oral or nasal airways cannot maintain a patent airway. Have the patient in an upright position such as sitting or semi-Fowler’s position. Place the patient in a sitting position on the side of the bed or in the semi- or high Fowler’s position. Exercise regularly—30 minutes, three to four times per week. Promote early ambulation and leg exercises to improve venous circulation. Author: Sandra Olive, respiratory nurse specialist, Norfolk and Norwich University Hospitals Foundation Trust. In patients who are acutely sick, this may not be possible and clinicians should act in the patient’s best interests, Place the oxygen mask on the patient’s face, adjusting the nose clip and elastic straps to ensure a close fit, Reassure the patient – if the patient is very breathless, oxygen masks can feel very claustrophobic, Monitor response to oxygen therapy – recheck oxygen saturations, vital signs, colour and level of consciousness, Titrate oxygen according to oxygen saturations (Fig 4) to maintain saturations within prescribed target range. Assist the patient into a sitting or high semi-Fowler’s position. Use energy conservation exercises such as performing the work part of an activity during, Preoperative teaching is important in providing patients with information regarding the risks of developing respiratory problems postoperatively. The FiO2 achieved cannot be predicted as it depends on the rate and depth of the patient’s breathing. Nursing Care Plan. There has been trauma to the upper airways. They do not need to be removed when the patient is talking or eating. Measure the oral airway along the patient’s jaw with the open end of the curve facing the patient’s neck to ensure that the airway is the correct size. Then, have the patient inhale deeply and exhale, closing his throat and using small coughs without inhaling again, pause, and then inhale again very slowly (to decrease the cough stimulus). ), Withdraw the catheter slowly, rotating it and applying suction only intermittently so as not to damage the airway walls. Chest physical therapy is composed of three techniques that may be used individually or in combination. Suction at least hourly to remove secretions. Proportion of room air added during breathing. The target saturation range is prescribed according to the risk of type 2 (hypercapnic) respiratory failure pending arterial blood gas measurement. Patients are intubated via the mouth or nose. You are also concerned about the … Oxygen therapy. Simple face masks should not be used for patients at risk of type 2 respiratory failure. Explain the procedure to the patient. Breathing exercises may help patients control breathing, improve. The amount of oxygen delivered by variable-performance devices (also known as uncontrolled oxygen systems) is dependent on the: Oxygen at 10-15L/min via a reservoir mask delivers oxygen at concentrations of 60-85% and is recommended for short-term use in patients who are critically ill. Answer: C Rationale: Getting the oxygen saturation through a pulse oximeter is quick and easy. Most ET tubes have a cuff at the distal end, which can be inflated with air via an external catheter to create a seal between the tube and the patient’s, Other conditions may allow for a minimal-leak seal to exist between the. It is essential to: Oxygen is delivered via variable-performance or fixed-performance devices. This was endorsed by 21 professional groups across a wide range of professions and specialties. Oxygen is inhaled even when breathing through the mouth. Ensure adequate ventilation of wood stoves and furnaces. Otherwise, scroll down to view this completed care plan. Where there is a risk of carbon dioxide retention (target 88-92%), start oxygen therapy using a 28% Venturi device and mask, Ensure delivery device is connected via tubing to oxygen supply and turned on to the appropriate flow rate (if cylinder, check fill level of cylinder and be aware of duration time), Explain procedure to the patient and gain consent where possible. A one-way valve prevents exhaled air entering the bag. Initial Diagnostics and Treatment Because of the SP02 reading, you apply a simple face mask with supplemental oxygen. Respiratory disorders interfere with the maintenance of airways, patterns of breathing, clearance of secretions, and exchange of gases. Venturi valves (Fig 3, attached) are colour-coded to denote the fixed percentage of oxygen delivered; these range from 24% (blue) to 60% (green), provided that the minimum oxygen flow rate on the barrel of the device is given.

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