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When administering oxygen therapy, it is important for the nurse to assess the patient before, during, and after the procedure and document the findings. Subjective AssessmentPrior to initiating oxygen therapy, if conditions warrant, the nurse should briefly obtain a history of respiratory conditions and collect data regarding current symptoms associated with the patient’s feeling of shortness of breath. The duration of this focused assessment should be modified based on the severity of the patient’s dyspnea. See Table 11.4 for focused interview questions related to oxygen therapy. This information is used to customize the oxygen delivery device and flow rate for the patient. For example, supplemental oxygen is typically initiated in nonemergency situations with a nasal cannula at 1-2 liters per minute (L/min), but a patient with a history of chronic obstructive pulmonary disease (COPD) may require a different device such as a Venturi mask. Table 11.4 Focused Interview Questions for Subjective Assessment of Dyspnea
Objective AssessmentPrior to applying supplemental oxygen, objective data regarding patient status should quickly be obtained such as airway clearance, respiratory rate, pulse oximetry, and lung sounds. Signs of cyanosis in the skin or nail bed assessment should also be noted. Within a few minutes after initiating oxygen administration, the nurse should evaluate for improvement of these indicators, and if no improvement is noted, then additional actions should be taken. At any point, if the nurse feels that the patient’s condition is deteriorating, emergency action should be taken such as calling the rapid response team or 911. Depending upon the severity of patient condition, serial ABG results may also be monitored to determine effectiveness of oxygenation interventions. After oxygen therapy is initiated, it is important to closely monitor for skin breakdown at pressure points. For example, nasal cannula tubing often causes skin breakdown in the nares or over the ears, so protective foam dressings may need to be applied. Life Span ConsiderationsChildrenDifferent sized oxygen equipment is used for infants and children. Additionally, oxygen tubing may need to be secured to a child’s face with tape to prevent them from pulling it off. For infants, the pulse oximeter probe is usually attached to the palm or foot. Older AdultsIf a patient is oxygen-dependent, ensure that extension tubing is applied so the patient is able to reach the bathroom with the oxygen device in place. However, be aware of the increased risk for falls due to the excess tubing. Keeping the oxygen tubing coiled up at the head of the bed or on the bedside table closest to the bathroom will decrease the patient’s risk of falling. Advise the patient to ask for assistance when getting up to use the restroom.
What precautions should be taken when oxygen is in use?Oxygen Safety Precautions. Notify the fire department and the electric company that you are using oxygen.. Place “Oxygen in Use” signs in visible areas.. Never place the tank or machine near an open flame (e.g., matches, lit candles, a stove in use). ... . Always turn your oxygen off when not in use.. What is the most important precaution when nurse administers oxygen therapy?Keep oxygen cylinders away from heat sources. Keep oxygen delivery systems at least 1.5 metres from any heat source. Check for electrical hazards in the home or hospital prior to use. Determine that electrical equipment in the room or home is in safe working condition.
What are the nursing responsibilities during administration of oxygen?Nurses have a responsibility to ensure that oxygenation is optimised at pulmonary and cellular level as part of their duty of care to patients. This requires knowledge of respiratory and cardiac physiology, as well as selection of the appropriate equipment and delivery method for supplemental oxygen therapy.
What nursing considerations should be made when delivering oxygen?Keep the oxygen at least five feet away from any heat source.. Avoid using equipment that could emit a spark.. Avoid wearing synthetic clothing due to static electricity.. Avoid use of flammable liquids.. No smoking.. Fire extinguisher readily available.. |