From the Guidelines
The oxygen delivery rate through a nasal catheter is 2-6 L/min, as recommended by the BTS guideline for oxygen use in adults in healthcare and emergency settings 1. When a patient develops constricting chest pain during an electoral procedure, the nurse should stop the procedure and call a doctor. For long-term oxygen therapy via nasal catheter, a break should be taken after 30-40 minutes. Oxygen therapy with defoamers is indicated for pulmonary edema, and 70% ethyl alcohol is used as the defoamer. Hemoptysis is a contraindication to inhalation therapy. For a general therapeutic bath, patients should be immersed in water up to the xiphoid process. Inhalation using a steam inhaler should be done 1-1.5 hours after eating. When using a pocket inhaler, the patient should cover the mouthpiece tightly with lips, take a deep breath while pressing the bottom of the inhaler. For oxygen therapy via nasal catheter, the catheter position should be changed to the other nasal passage every 30-40 minutes. An oxygen concentration of 30% in the oxygen-air mixture is sufficient to eliminate tissue hypoxia. If a patient develops nasal irritation during oxygen therapy, the nurse should temporarily stop oxygen administration and drip oil drops into the nose. When administering oxygen via mask, the error would be pressing the mask tightly against the patient's mouth. If a patient's condition doesn't improve after multiple inhaler uses, the nurse should call the doctor. When using a pocket inhaler, the error in the algorithm is that the patient should take a deep breath in (not out) while pressing the bottom. Oxygen pressure in cylinders is 150 atm. The most common non-invasive way to measure oxygenation is pulse oximetry. For a patient with an asthma attack, the nurse should use a pocket inhaler with Salbutamol. Water in a thermal inhaler should be heated to 50°C. If a patient becomes pale with headache and other symptoms during a warm bath, the nurse should urgently stop the procedure and call a doctor.
Some key points to consider:
- The BTS guideline recommends the use of nasal cannulae for medium-concentration oxygen therapy, with a flow rate adjusted between 2 and 6 L/min to achieve the desired target saturation 1.
- The guideline also recommends the use of Venturi masks for patients requiring precise control of FiO2, which can deliver a constant FiO2 of 24%, 28%, 31%, 35%, 40%, and 60% oxygen with a greater gas flow than a simple face mask 1.
- Humidification of oxygen is not required for the delivery of low-flow oxygen or for the short-term use of high-flow oxygen, but it may be beneficial for patients with upper airway discomfort due to dryness or with viscous secretions causing difficulty with expectoration 1.
From the Research
Oxygen Delivery Rate
- The oxygen delivery rate for a patient given humidified oxygen through a nasal catheter is typically in the range of 2-6 L/min 2, 3.
Nurse Actions During Constricting Pains
- If a patient develops constricting pains in the region of the heart, palpitations during a procedure, the nurse should stop the procedure and call a doctor.
Break Period for Nasal Catheter Oxygen Therapy
- A break should be taken every 1-2 hours when a patient is given humidified oxygen through a nasal catheter for a long period.
Indications for Oxygen Therapy with Defoamers
- Indications for oxygen therapy combined with inhalation of defoamers include respiratory failure, pulmonary edema, and right ventricular heart failure 2, 3.
Defoamer Used in Oxygen Therapy
- The defoamer used in oxygen therapy is typically 96 degree of ethyl alcohol.
Contraindications to Inhalation Therapy
- Contraindications to inhalation therapy include hemoptysis and shortness of breath.
Immersion Level for General Therapeutic Bath
- A patient can be immersed in water up to the level of the xiphoid process during a general therapeutic bath.
Timing of Inhalation Procedure
- The inhalation procedure using a steam inhaler should be carried out 1-1.5 hours after eating.
Patient Actions with Pocket Inhaler
- When using a pocket inhaler, the patient should cover the mouthpiece tightly with their lips, take a deep breath, and at the same time press the bottom of the inhaler.
Nurse Actions with Nasal Catheter
- The nurse should change the position of the catheter into the other nasal passage every 1-2 hours when a patient is given oxygen through a nasal catheter.
Oxygen Content to Eliminate Tissue Hypoxia
- The oxygen content in the oxygen-air mixture that eliminates the state of tissue hypoxia is typically 30-50% 2, 3.
Nurse Action for Nasal Irritation
- If a patient develops irritation in the nose and nasopharynx during oxygen therapy, the nurse should temporarily stop the introduction of oxygen and drip oil drops into the nose.
Mistake in Nurse Actions with Oxygen Mask
- A mistake in the actions of a nurse when giving oxygen therapy using a mask is pressing the oxygen supply mask tightly against the patient's mouth.
Nurse Actions for Asthma Attack
- If a patient complains of an asthma attack and their condition does not improve after using a pocket inhaler, the nurse should call a doctor.
Error in Pocket Inhaler Algorithm
- An error in the algorithm of actions when using a pocket inhaler is not shaking the inhaler before use.
Oxygen Pressure in Cylinders
- The oxygen pressure in cylinders is typically 200 atm.
Common Method to Measure Oxygenation
- The most common and non-invasive way to measure a patient's oxygenation is using a pulse oximeter.
Nurse Actions for Bronchial Asthma
- If a patient with bronchial asthma complains of an asthma attack, the nurse should use a pocket inhaler with the drug "Salbutamol".
Water Temperature for Thermal Inhaler
- The nurse must heat the water in a thermal inhaler to 40-50°C.
Nurse Actions for General Therapeutic Bath
- If a patient turns pale, complains of headache, heartache, dizziness during a general therapeutic bath, the nurse should urgently stop the procedure and call a doctor.