3310 oxygen therapy

early signs of hypoxia

compensating

restlessness, anxiety, tachycardia, tachypnea, HTN, pallor, abnormal breathing, use of accessory muscles

late signs of hypoxia

failing

altered level of consciousness, bradycardia, bradypnea, hypotension, cyanosis, dysrhythmias

oxygen toxicity

high O2 concentration that causes nonproductive cough and substernal pain

endotracheal tube nursing management

respiratory assessment, VS including end tidal CO2, cuff pressure assessment (20-30cm H2O), skin assessment, oral care every shift, monitor secretions, depth/placement every shift and PRN

tracheostomy

surgically created stoma used to establish patent airway, facilitate secretion removal, permit long-term mechanical ventilation, facilitate weaning from mechanical ventilation

advantages of trach

easier to keep clean, better oral and bronchial hygiene, more patient comfort, less risk of long-term damage to vocal cords, can be used long-term or permanently, patient/family can easily care after discharge

trach nursing management

assess respiratory status, perform routine maintenance/care, emergency equipment at bedside, educate patient and family

nasal cannula flow rate

1-6L/min

nasal cannula FiO2

24-40%

nasal cannula use

for stable, non-critical patient

simple mask flow rate

5-10L/min

simple mask FiO2

30-60%

simple mask use

moderate O2 needs

venturi mask flow rate

4-10L/min

venturi mask FiO2

24-60%

venturi mask use

precise, fixed O2 needs

non-rebreather flow rate

10-15L/min

non-rebreather FiO2

60-100%

non-rebreather use

critically ill patients with severe hypoxemia