CHILD HEALTH NURSING
Oxygen Therapy (lectures) - by Mrs Sunita Bhandari (Shah)
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| Introduction | ||||||||||||||||
| —Oxygen is essential for human survival. —Inspired air contains 21percent of oxygen —It is carried in the body largely in combination with hemoglobin and a small quantity is transported in physical solution in plasma. —Each molecules of hemoglobin can bind up to four molecule of oxygen and each gram of hemoglobin can carry approximately 1.34ml of oxygen —In persons with normal lungs breathing room air, the dissolved portion of oxygen in plasma is only 2 percent of total. If the some person is exposed to 100 percent oxygen, the amount of dissolved oxygen may approach to 10 percent of whole. |
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| Indication for oxygen therapy | ||||||||||||||||
| —Hypoxia secondary to any cause: - respiratory, cardiovascular,
or neurological. —To raise the arterial and alveolar oxygen levels above physiological limits as in carbondioxide poisoning, abnormal hemoglobin |
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| Clinical features of acute hypoxemia | ||||||||||||||||
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| The WHO recommends that oxygen should be administered to a child with | ||||||||||||||||
| —Central cyanosis/ inability to drink —Grunting in infant<2 months of age —Tachypnoea, restlessness, chest indrawing |
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| Oxygen saturation (Aerial blood) | ||||||||||||||||
| —Newborn 40-90% —Thereafter 95-99% |
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| Oxygen therapy | ||||||||||||||||
| —Oxygen may be classified as an element, a gas, and a drug. Oxygen therapy is the administration of oxygen at concentrations greater than that in room air to treat or prevent hypoxemia (not enough oxygen in the blood). | ||||||||||||||||
| Purposes | ||||||||||||||||
| —oxygen levels in the blood decrease, and the patient
may need supplemental oxygen. —Oxygen therapy is a key treatment in respiratory care. —To increase oxygen saturation in tissues where the saturation levels are too low —Reduces the extra work of the heart, and decreases shortness of breath |
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| To accomplish this | ||||||||||||||||
| —O2 must be given in higher concentration than present
in air. —It is given in concentration of from 40 to 60 or even 100% through face mask. |
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| Source: | ||||||||||||||||
| —Wall outlet (from central source) —Steel cylinder or tank |
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| Oxygen flow rate: | ||||||||||||||||
| —Measured in liter perminuts —Rate varies depending on the condition of the client and route of administration of the oxygen Humidifying oxygen: use distilled water or sterile waters Warming: 36∙c to 37.c (room temperature) —Cold O2 cause cold stress and collapse of lungs alveoli in premature infant. |
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| Precautions for oxygen administration: | ||||||||||||||||
| —Combustion: oxygen is not combustible itself but it enhances
combustion. —Avoid open flames in the client’s room. —Place on smoking signs instruct visitors on the hazard of smoking with oxygen use. —Check electric equipments need in the room, is all equipment in good working condition and emits no park. —Avoid wearing and using synthetic fabrics that build up static electricity. —Avoid using oils in the area. Oil can ignite spontaneously in the presence of oxygen. |
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| Oxygen administration: | ||||||||||||||||
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| Article requirement: | ||||||||||||||||
| —Oxygen cylinder with regulator fitments. —Opening key. —Humidifier. —Nasal tubes. —Rubber tubing —Adhesive tape —Cylinder step —Oxygen mask if available. —Cotton swab to clean the nostrils |
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| Procedure: | ||||||||||||||||
O2 should be warmed to room temperature and humidified before it is given to prevent chilling the child and drying of secretion in the respiratory tract. Regardless of the type of O2 equipment used each child’s chart should contain a separate oxygen record that should include —Physician written order for oxygen and its method of
administration |
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| —explain the procedure and tell them why it is require
—Check the cylinder; open the valve away from patient. —Fill humidifier half filled with water. —Attach the tubing of humidifier and oxygen cylinder and outlet of humidifier to the patient. —Unscrew regulator and allow release of oxygen from cylinder which can be observed from bubbling of water in humidifying bottle. |
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| —Now check nasal catheter by dipping in a bowl of water
and see for bubbling. Now you are sure that the flow of oxygen
is correct. —now close the regulator to stop flow of oxygen —lubricate the catheter —Determine the approximate depth to which the catheter is to be inserted by measuring distance from external nostril, to tragus of ear and mark the distance of catheter. (about 8cm) clean the nostril by swab —now release and adjust regulator to provide 4 to 8 liters oxygen per minute —insert the catheter slowly |
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| Complication: | ||||||||||||||||
| —O2 toxicity: retrolenhal fibroplasias —O2 induced carbondioxide narcosis |
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| Nebulization therapy | ||||||||||||||||
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| What is nebulization? | ||||||||||||||||
| A nebulizer changes liquid medicine into fine droplets (in aerosol or mist form) that are inhaled through a mouthpiece or mask. Nebulizers can be used to deliver bronchodilator (airway-opening medicines) | ||||||||||||||||
| Nebulizer care guidelines | ||||||||||||||||
| —Air compressor —Nebulizer cup —Mask or mouthpiece —Clean eye droppers or other measuring devices to dispense the medication |
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