Oxygen Therapy: Administration and Safety

• Oxygen (O2) is a colorless, odorless, and tasteless gas vital for life; without it, death occurs within minutes.
• Oxygen enters the body through the airway, which includes the nose, mouth, breathing tube, or tracheostomy, and goes to the lungs
• Some clients need supplemental oxygen via nasal tube or face mask.
• Support workers need to know how to safely and effectively care for these clients.
• Oxygen therapy involves administering oxygen at concentrations greater than room air.
• Prescribing oxygen therapy, including the amount, device type, and therapy times, can only be done by a physician or nurse practitioner.
• Respiratory therapists or nurses usually set up oxygen devices and lead respiratory care activities.
• Respiratory therapists evaluate, treat, maintain heart and lung function, and aid clients in breathing.
• Some need oxygen continuously, while others need it for symptom relief like chest pain or shortness of breath.
• Administering too much oxygen can dangerously slow a client's respiratory rate
• Before assisting with care, ensure the task is within your scope of practice, job description, and training, you know how to use the equipment, and have reviewed it with a nurse.
• Always have a nurse or respiratory technician supervise you.

Altered Respiratory Function

• The function of the respiratory system involves air moving in and out of the lungs.
• The function of the respiratory system involves O2 and CO2 exchange at the alveoli.
• The function of the respiratory system involves blood transporting O2 to the cells and removing CO2.
• Shortness of breath (SOB) or shortness of breath on exertion (SOBOE) indicates altered respiratory function, which can be acute or chronic.
• Clients unable to breathe easily may panic, become uncomfortable, struggle to breathe, and prefer sitting up (orthopnea).
• Difficulty breathing is exhausting and dangerous, requiring prompt and accurate reporting to a supervisor.
• Never adjust a client's oxygen level unless directed by the care plan, as it can cause extreme harm.

Signs and Symptoms of Altered Respiratory Function

• Hypoxia signs and symptoms
• Abnormal breathing pattern
• Complaints of shortness of breath or being "winded" or "short-winded"
• Cough (note frequency and time of day)
• Dry and hacking
• Harsh and barking
• Productive (produces sputum) or nonproductive
• Clear, white, yellow, green, brown, or red Sputum color.
• Odor of sputum - none or foul
• Sputum Consistency - thick, watery, or frothy (with bubbles or foam)
• Hemoptysis—bloody (hemo) sputum (ptysis, meaning “to spit”); sputum is bright red, dark red, blood-tinged, or streaked with blood
• Noisy respirations
• Wheezing
• Wet-sounding respirations
• Crowing sounds
• Chest pain
• Location
• Constant or intermittent (comes and goes)
• Client's description (stabbing, knifelike, aching)
• What makes it worse (movement, coughing, yawning, sneezing, sighing, deep breathing)
• Cyanosis
• Skin
• Mucous membranes
• Lips
• Nail beds
• Changes in vital signs
• Body position
• Sitting upright
• Leaning forward or hunched over a table

Abnormal Respiratory Patterns

• Normal respiration rate for adults is 12 to 20 per minute.
• Infants and children have faster rates.
• Normal respirations are quiet, effortless, and regular, with both sides of the chest rising and falling uniformly
• Eupnea is the medical term for normal respirations.
• Tachypnea involves rapid (tachy) breathing (pnea) and respirations of 20 or more per minute. Common causes are fever, exercise, pain, airway obstruction, and hypoxemia.
• Bradypnea involves slow (brady) breathing (pnea) and respirations fewer than 12 per minute and common causes are drug overdoses and nervous system disorders.
• Apnea is the lack or absence (a) of breathing (pnea) and occurs in cardiac and respiratory arrest; sleep apnea in adults and periodic apnea in newborns are other types of apnea.
• Kussmaul respirations involve deep and rapid respirations characteristic of diabetic acidosis or other conditions causing acidosis.
• Hypoventilation involves slow (hypo), shallow, and sometimes irregular respirations and common causes includes lung disorders (such as pneumonia), obesity, airway obstruction, adverse effects of drugs, and nervous system and musculoskeletal disorders affecting the respiratory muscles.
• Hyperventilation involves rapid (hyper) and deeper-than-normal respirations and common causes: asthma, emphysema, infection, fever, nervous system disorders, hypoxia, anxiety, pain, and some drugs.
• Dyspnea-difficult, laboured, or painful (dys) breathing (pnea) and common causes: heart disease, exercise, and anxiety.
• Cheyne-Stokes respirations gradually increase in rate and depth, then become shallow and slow; breathing may stop (apnea) for 10 to 20 seconds and common causes: drug overdose, heart failure, renal failure, and brain disorders. These respirations commonly occur near death.
• Orthopnea involves shortness of breath (dyspnea) when lying in a flat or supine position, with the ability to breathe comfortably (pnea) only when sitting or standing (ortho) and common causes: emphysema, asthma, pneumonia, angina pectoris, and other heart and respiratory disorders.

Hypoxia

• Hypoxia is a deficiency (hypo) of oxygen in the cells (oxia), resulting from abnormal respiratory functioning caused by illness, disease, injury, or surgery.
• Hypoxia is life-threatening because cells require oxygen to function and will be damaged or die without it.

Signs and Symptoms of Hypoxia

• Restlessness
• Dizziness
• Disorientation
• Confusion
• Behaviour and personality changes
• Difficulty concentrating and following directions
• Apprehension
• Anxiety
• Fatigue
• Agitation
• Increased pulse rate
• Sitting position, often leaning forward
• Cyanosis is an abnormal condition evidenced in light-skinned clients by bluish colour in the skin, mucous membranes(lips, gums, and around the eyes), and nail beds and in darker-skinned clients, cyanosis may be easiest to see in the mucous membranes and nail beds
• Increased rate and depth of respirations
• Dyspnea

This lesson covers the importance of oxygen therapy, emphasizing the roles and responsibilities of support workers in assisting clients who require supplemental oxygen. It highlights the necessity of understanding safe and effective oxygen administration techniques. It also outlines the different devices, therapy times and the importance of correct dosage.