Oxygen Therapy and Delivery Devices Study Notes

Oxygen Therapy and Delivery Devices

Oxygen Delivery Devices

• Review the table in the book (possibly page 343 or 341) and/or the slides to understand how many liters of oxygen can be delivered via each device.
• Be aware of the limitations of each device to prevent harm to the patient.

Delegation

• Adjusting oxygen levels should not be delegated to unlicensed assistive personnel (UAPs).
• Delegation will be a topic covered in the NCLEX exam.

Initial Steps

• Ensure the oxygen device is correctly hooked up to the oxygen supply.
• Oxygen is typically indicated by a green connector, while regular air is indicated by yellow.

Common Mistakes

• Be vigilant about ensuring the patient is connected to oxygen and not air, as mistakes can happen, especially during patient transfers.

Humidification

• Adding humidity to oxygen can prevent nosebleeds and dryness, especially with nasal cannulas.
• A bottle, typically filled with sterile water, is used to humidify the oxygen.

Liter Flow and Device Selection

• It is crucial to know which oxygen delivery device to use based on the physician's order and the prescribed liter flow.
• Never administer excessive oxygen flow (e.g., 10 liters via nasal cannula) as it can harm the patient.

Patient Education: Smoking

• Instruct patients receiving oxygen therapy to avoid smoking due to fire risk.
• Smoking can cause the oxygen tubing to melt, leading to burns and further respiratory issues.
• Even with no-smoking policies in hospitals, constant vigilance is needed.

COPD Considerations

• Be cautious with oxygen administration in COPD patients, as excessive oxygen can be detrimental.
• Avoid drastically increasing oxygen levels, even if the patient's oxygen saturation is low (e.g., 85-87%).

Skin Breakdown

• Regularly check for skin breakdown in patients on continuous oxygen via nasal cannula.
• Pay close attention to the areas behind the ears and on the face where the device touches the skin.
• Use padding (e.g., 2x2 gauze) to prevent pressure ulcers.
• Avoid overly tight placement of the nasal cannula to prevent skin breakdown on the cheeks.

Safety Precautions

• Refer to Box 14.1 on page 344 for comprehensive safety precautions during oxygen use.

Skill Checklists

• Review the yellow pages, which are skill checklists, for guidance on proper oxygen administration.
• Familiarize yourself with the correct way to place oxygen devices, as patients may sometimes wear them incorrectly.

Endotracheal Tubes (ET Tubes)

• ET tubes are used to maintain a patent airway, often connected to a ventilator in the ICU.
• Patients with ET tubes in the ICU are typically heavily sedated.

Tracheostomy

• Tracheostomies are artificial airways that can be temporary or permanent.
• Maintaining the airway is the primary concern.
• Patients with tracheostomies can develop mucus plugs.

Tracheostomy Suctioning

• Read the section on tracheostomy suctioning on page 351 and watch a YouTube video for a demonstration.
• Although respiratory therapists usually perform suctioning, nurses must know how to do it in emergencies.

Yankauer Suction

• The Yankauer suction (pictured on page 358) is used to suction secretions from the mouth only, not the throat or lungs.
• It is beneficial for patients who can cough up secretions but cannot clear their mouth.
• It is essential to prevent aspiration.

Setting Up Suction

• Setting up suction at the bedside is a nursing judgment, especially for patients at risk of aspiration (e.g., stroke patients).
• For patients with a trach, suction should always be readily available and set up.

Key Areas to Review

• Trach suctioning section (yellow pages from page 351).
• Trachea care section.
• Oxygen devices and the corresponding liter flow for each.