Care of gas exchange and respiratory function care modalities

Non invasive respiratory therapies

• The goal of oxygen therapy is providing adequate o2 wile decreasing the load of breathing and reducing stress on heart.

Non invasive respiratory therapies

• Indication: 1. Change in respiratory rate or pattern:

hypoxemia or hypoxia.2. Hypoxemia is decrease in the arterial oxygen

tension in the blood.3. Hypoxemia leads to hypoxia which is

decrease O2 supply to the tissues.

Question to think about

• What are the three methods to assess oxygen level in the blood?

Complication • It is considered as medication. And it is used with

prescription.• Oxygen toxicity: when administering more than 50% for

more than 48hrs.• Suppression of ventilation: the stimulus of respiration is

O2 if it is give in high dose it will suppress the respiratory center as in COPD.

• Other complication: O2 supports combustion so dangerous for fire so put “oxygen on use” sign. Change the tubing and its device between patients to reduce the risk for infection.

Methods of oxygen administration

• It is dispensed from cylinder or a pipe in system (central line).

• Humidifier is use to prevent dryness of mucous membrane.

1. Nasal cannula is used to provide low to medium amount of O2.

2. Oropharyngeal is used for short term therapy for low and moderate concentration of oxygen. It should be changed every 8hrs.

3. Oxygen mask:a. Simple mask: gives low to moderate o2. it has opening for exhalation and draw air when o2 ceases. Adjust it properly to the skin but not to press tightly to prevent skin break down. (you can put gauze around the ear).

b. Partial re-breather mask: has reservoir bag which must remain inflated during inspiration and expiration. High doses of O2 can be administer as both mask and bag act as reservoir for o2.

c. Non re-breather mask: it has valve to allow air to go to the mask but not opposite. It allows exhaled air to exit the mask during exhalaiton.

d. Venturi mask: it is accurate for delivering o2.e. Other oxygen delivery include aerosole masks, tracheostomy collars and face tent.

• face tent

Nursing management:

1. Teach patient that it is available in gas, liquid and concentrated forms.

2. Sign of “o2 in use to be put”3. If it is in portable device patient can leave the

house or hospital with it.4. Humidity must be provided.

• Compare and contrast between various types of low and high flow systems page 637.

Thank You