Oxygen Therapy Exam 1 Review

Oxygen Therapy and Hypoxia

• Hypoxia early signs include restlessness, confusion, anxiety, increased heart rate (HR), elevated blood pressure (BP), rapid respiratory rate (RR), dyspnea, and use of tripod stance for accessory breathing.
• Late signs of hypoxia involve decreased activity levels, lower HR, cyanosis, pallor, accessory breathing, and altered level of consciousness (ALOC).
• Chronic hypoxia signs consist of nail clubbing and peripheral pallor.
• COPD patients maintain oxygen saturation (O2 Sat) safely around 88-92%.

O2 Delivery Methods

• Low flow delivery: Oxygen flow rates exceed 42 liters/min for good humidification; sterile water used and replaced every 24 hours.
• Start low and titrate slowly up for O2 therapy; no doctor's order required for emergency use.
• Nasal Cannula: Delivers 24-75% O2, at flow rates of 1-6 L/min; can be used on any patient, avoid bag deflation.
• Venturi Mask: Provides precise control of O2 delivery (4-10 L/min, 24-50% O2); primarily used in ICU and for COPD patients needing exact concentrations.
• Face Tent: Offers an alternative for aerosol masks post-oral or nasal surgery, delivering 24-100% O2 at ≥10 L/min.
• Ambu Bag (CPR bag): Used to assist or provide breathing for patients with respirations <12/min, delivering ~50% O2; applicable for pediatric cases with respiratory issues.
• Trach Collar: Utilizes a T-piece with humidifier at typically 10 L/min.
• Nebulizer: Administers aerosolized medications.
• Incentive Spirometer: Encourages deep inhalation to prevent pneumonia and atelectasis; aim for 10 times/hour.

Noninvasive Ventilation

• CPAP: Maintains set positive airway pressure for sleep apnea.
• BIPAP: Provides inspiratory assistance and keeps airways open during expiration.

Oxygen Cylinders

• Compressed O2 systems are common for home use; hospitals utilize bulk liquid O2 systems.
• E cylinder considered the most common size; maintain 10 feet from flames and keep a clutter-free environment.
• Caution with electrical equipment and avoid electric/friction toys.

Best Practices for Oxygen Therapy

• Position patients in semi or high-Fowler's for optimal breathing.

Vital Signs Overview

• Respirations: Normal range is 12-20 breaths per minute.

  • Tachypnea: >20 breaths/min.
  • Bradypnea: <12 breaths/min.
  • Cheyne-Stokes Respiration: Alternating periods of rapid/deep and slow/shallow breathing (indicates CNS issues).
  • Kussmaul's Respiration: Rapid and deep, commonly associated with ketoacidosis.
  • Biots: Rapid, shallow, and irregular respirations (often linked to CNS issues).
  • Apnea: Absence of breathing.

• Pulse: Normal range is 60-100 BPM, can be regular or irregular.

  • Tachycardia: >100 BPM.
  • Bradycardia: <60 BPM.