Unit 11  Oxygen therapy

Objective:

1.   To correct hypoxic（缺氧的) condition.

2.   To return arterial PO2 and SO2 to normal oracceptable range.

3.To increase client’s comfort,breathing efficiency, and activity tolerance

Using an oxygen cylinder

Equipment:

Source of oxygensupply : oxygen cylinder or oxygen tank（氧氣筒)

Oxygen gauge（氧氣壓力表)

Oxygen flowmeter（流量表)

Humidifier （濕化瓶)

Rubber tubing (橡膠管)

Procedure:

1.   Place oxygen cylinder in secure, uprightposition.

2.   Check tag（標(biāo)簽) todetermine amount of oxygen in the tank. Tag should be read “full”.

3.   Slowly turn hand knob(總閥) on cylinder clockwise to crack tank open for a briefsecond to clear opening of tank; then close.

4.   Attach oxygen gauge to valve outlet（氣門). Place oxygen gauge in upright position.

5.   Fill humidifier with distilled water（蒸餾水) to indicated level on bottle. Humidity preventsmucous membranes（黏膜)from drying out.

6.   Attach top of humidifier to oxygen flowmeter .

7.   Attach one side of rubber tubing to flowmeter.

8.   Turn off hand wheel（流量調(diào)節(jié)閥), turn oxygen cylinder hand knob to open flow. Thenslowly open hand wheel and check if醫(yī)學(xué)全在線 the whole set of devices are applicable.

9.   Turn off the hand wheel, bring tank toroom.

Using a nasal catheter（鼻導(dǎo)管)

Equipment:

Oxygen source:oxygen tank

Kidney basin （彎盤)

Nasal catheter （鼻導(dǎo)管)

Hemostatic forceps（止血鉗)

Therapeutic bowl（治療碗) with distilled water

Swab （棉簽)

Adhesive tape （膠帶)

Record card（記錄單)

A smell pin （小別針)

Procedure :

1.   Check physician’s orders for oxygenprescription.

2.   Gather equipment.

3.   Place a small square plate （小方盤)on a equipment car .

4.   Wash your hands,  wear a mask.

5.   Pick out a therapeutic bowl and a kidneybasin from sterile storage container （無菌儲物罐),put them into the plate .then pick out a nasal catheter and a hemostatic forceps into the basin .

6.   Pour some distilled water into the bowl.

7.   Put other equipments ( a small pin, swab,two pieces of adhesive tape and record card ) orderly into the plate, thenbring to room .

8.   Check oxygen supply devices once again.

9.   Identify correct client, explain thepurpose and procedure of oxygen therapy briefly to client.

10.  Examine nostrils（鼻孔), and select the most patent(開放) nostril by having client breathe through each one.The nostril with greater airflow should be chosen for insertion（插入).Clean nasal cavity（鼻腔) withwet swab.

11.  Connect one side of nasal catheter to freeend of rubber tubing.

12.  Turn on oxygen flowmeter,then put the end of the nasal catheter in bowl to lubricate（潤滑) it .This also was done to observe if bubbling(起泡)occurred indicating that the catheter was patency.（開放)

13.  Turn off oxygen flowmeter , disconnect thenasal catheter from the rubber tubing .

14.  Measure from tip of nose to earlobe

（耳垂), two thirds of the length

 is appropriate for tube insertion.

15.  Insert tube gently through nostril to nasopharynx（鼻咽)

16.  Tape(以膠布固定) tubesecurely to nose and cheek:

a. place unsplit endof tape over bridge of nose with bifurcated （分為兩部分的)endshanging free.

a. Wrap（纏繞) eachend of tape around the tube as it exits from the nose .

17.  Turn on oxygen flow to liters （升)prescribed

18.  Connect nasal catheter to the rubbertubing.

19.  Secure tubing with pin to bed linen,leaving some degree of slack（松弛) for head movement.

20.  Write down time and flow of oxygen supplyon the record card.

21.  Assist client to a comfortable position.

Removing a nasal catheter

Equipment :

Kidney basin（彎盤) with two pieces of gauze（紗布) in it .

Procedure

1.   Disconnect the nasal catheter from therubber tubing.

2.   Turn off oxygen cylinder hand knob.

3.   Loosen tape on the nose and cheek.

4.   Take a piece o執(zhí)業(yè)獸醫(yī)f gauze in each hand andremove nasal catheter with continuous steady pull.

5.   Clean client’s face, especially nares.

6.   Unpin tube from sheet.

7.   Turn off the hand wheel of flowmeter and record the finished time of procedure.

8.   Dispose of equipment appropriately.