Chapter 5. Oxygen Therapy
Assessment for hypoxia can be done by completing a medical history, determining current medical condition, and performing a respiratory assessment. If a patient is experiencing any of the signs and symptoms listed in Table 5.2, hypoxia may be present.
Hypoxia must be treated immediately by the health care provider, as a lack of oxygen to tissues and organs can create serious complications (Alberta Health Services, 2015).
Table 5.2 Signs and Symptoms of Hypoxia
Signs and Symptoms
|Tachypnea||Increased respiration rate is an indication of respiratory distress.|
|Dyspnea||Shortness of breath (SOB) is an indication of respiratory distress.|
|Use of accessory muscles||Use of neck or intercostal muscles when breathing is an indication of respiratory distress.|
|Noisy breathing||Audible noises with breathing, or wheezes and crackles, are an indication of respiratory conditions. Assess lung sounds for adventitious sounds such as wheezing or crackles. Secretions can plug the airway, thereby decreasing the amount of oxygen available for gas exchange in the lung.|
|Decreased oxygen saturation levels||Oxygen saturation levels should be between 92% and 98% for an adult without an underlying respiratory condition. Lower than 92% is considered hypoxic. For patients with COPD, oxygen saturation levels may range from 88% to 92%. Lower than 88% is considered hypoxic.|
|Flaring of nostrils or pursed lips||Patients who are hypoxic may breathe differently, which may signal the need for supplemental oxygen.|
|Skin colour of patient||Changes in skin colour to bluish or gray are a late sign of hypoxia.|
|Position of patient||Patients in respiratory distress may voluntarily sit up or lean over by resting arms on their legs to enhance lung expansion. Patients who are hypoxic may not be able to lie flat in bed.|
|Ability of patient to speak in full sentences||Patients in respiratory distress may be unable to speak in full sentences, or may need to catch their breath between sentences.|
|Change in mental status or loss of consciousness (LOC)||This is a worsening and a late sign of hypoxia.|
|Restlessness or anxiety||This is an early sign of hypoxia.|
|Data source: O’Driscoll et al., 2008; Perry et al., 2018|
Critical Thinking Exercises
- Your patient is tachypneic and dyspneic. What is the first step you should take to ensure maximal lung expansion?
- Your patient is sitting up in high fowler’s position, but is still showing signs of hypoxia. What would be your best steps?