{"id":135,"date":"2019-09-12T22:20:22","date_gmt":"2019-09-13T02:20:22","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/?post_type=chapter&#038;p=135"},"modified":"2020-03-23T17:48:17","modified_gmt":"2020-03-23T21:48:17","slug":"5-2-oxygen","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/chapter\/5-2-oxygen\/","title":{"raw":"5.2 Oxygen","rendered":"5.2 Oxygen"},"content":{"raw":"<h2 style=\"text-align: center\"><strong>Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\r\n<ol>\r\n \t<li><strong>Explain how you might know if your patient is hypoxic or hypoxemic?<\/strong><\/li>\r\n<\/ol>\r\n<em>\u00a0<\/em><em>Answer: Hypoxia = arterial oxygen tension or partial pressure of oxygen PaO2 is below normal (&lt;80 mmHg) and is measured by ABGs.\u00a0 Hypoxemia = reduction of oxygen supply to the tissues and is measured by pulse oximetry SpO2. <\/em><em>A person can have hypoxemia but is compensating through increased HR \/ increasing oxygen supply.<\/em>\r\n\r\nSources: Alberta Health Services. (2015)<em>. Oxygen therapy for acute adult inpatients. Learning module for Allied Health staff (category 1 and 2). <\/em><em><a href=\"http:\/\/www.albertahealthservices.ca\/assets\/info\/hp\/edu\/if-hp-edu-ahc-oxygen-therapy-learning-module-cat-1and2.pdf\">http:\/\/www.albertahealthservices.ca\/assets\/info\/hp\/edu\/if-hp-edu-ahc-oxygen-therapy-learning-module-cat-1and2.pdf<\/a>.<\/em>\r\n\r\nConsidine, J. (2007). <em>Emergency assessment of oxygenation<\/em>.\u00a0 <a href=\"https:\/\/acutecaretesting.org\/en\/articles\/emergency-assessment-of-oxygenation\">https:\/\/acutecaretesting.org\/en\/articles\/emergency-assessment-of-oxygenation<\/a>.\r\n\r\nFournier,\u00a0 M. (2014). Caring for patients in respiratory failure. <em>American Nurse Today<\/em>, <em>9<\/em>(11).\u00a0 <a href=\"https:\/\/www.americannursetoday.com\/caring-patients-respiratory-failure\/\">https:\/\/www.americannursetoday.com\/caring-patients-respiratory-failure\/<\/a>\r\n<ol start=\"2\">\r\n \t<li><strong>Why might the post surgical patient require supplemental oxygen?<\/strong><\/li>\r\n<\/ol>\r\n<em>\u00a0<\/em><em>Answer: Sedation from general anesthetics, sedatives, analgesics can cause \u2193respiratory rate \u2192inadequate ventilation = need for supplemental oxygen <\/em><em>AND<\/em><em> DB&amp;C exercises<\/em>\r\n\r\n<em>Source:\u00a0<\/em>Perry, A., Potter, P., Ostendorf, W. (2017). \u00a0<em>Clinical Skills and Techniques<\/em> (9th ed.) Elsevier; Mosby.\r\n\r\n&nbsp;\r\n<p class=\"textbox shaded\" style=\"text-align: center\"><strong>Sample Quiz Questions<\/strong><\/p>\r\n\r\n<ol>\r\n \t<li><strong>Hilde. Age 59. History of smoking for 59 years is one day post op open cholecystectomy. Which of the following statements correctly reflect the nurse\u2019s thinking when caring for her?<\/strong> Select all that apply.<\/li>\r\n<\/ol>\r\n<ul>\r\n \t<li>Hilde is at risk for atelectasis post op <em>Answer: true. Post operatively patients are at risk for atelectasis due to pain and guarding which can result in diminished breaths eventually leading to atelectasis.<\/em><\/li>\r\n \t<li>Pain management along with ambulation and deep breathing and coughing should be encouraged approximately q2h. <em>Answer: true. Pain management often improves the ability to deep breathe and cough and ambulate. Both of these will allow Hilde to take deep breaths, improve\u00a0 ventilation and reduce risk of atelectasis<\/em><\/li>\r\n \t<li>Lower than normal SpO2 is normal for Hilde. <em>Answer: true. Hilde has smoked for 59 years. She may or may not have a diagnosis of lung disease. We know persons with COPD are expected to have below normal Spo2. The nurse should encourage DB&amp;C, ambulation and consult the prescriber for oxygen orders and an acceptable SpO2 for Hilde. Generally for persons with COPD the SpO2 target range is 88-92% because of the lung changes associated with the disease.<\/em><\/li>\r\n<\/ul>\r\nSource: Abdo, W., Heunks, L. (2012). Oxygen induced hypercapnia in COPD: myths and facts. <em>Critical Care, 16<\/em>(5).\u00a0 doi:\u00a0 <a href=\"https:\/\/dx.doi.org\/10.1186%2Fcc11475\" target=\"pmc_ext\" rel=\"noopener noreferrer\">10.1186\/cc11475<\/a>\r\n<ol start=\"2\">\r\n \t<li><strong>Use of Incentive inspirometry is an effective strategy to decrease risk of atelectasis and optimize oxygenation in the post op patient. True or False.<\/strong><\/li>\r\n<\/ol>\r\n<em>Answer: false. The evidence to support the use of routine use of incentive inspirometry to prevent post op respiratory complications is not strong.<\/em> <em>However ambulation, deep breathing and coughing are effective strategies and must be integrated along with effective pain management in order to reduce risk of respiratory related post op complications..<\/em>\r\n\r\n<em>\u00a0<\/em>Sources:\r\n\r\nEltorai, A., Szabo et al. (2017 )Clinical Effectiveness of Incentive Spirometry for the Prevention of Postoperative Pulmonary Complications. <em>Respiratory Care<\/em>.\u00a0 DOI: 10.4187\/respcare.05679\r\n\r\nStrickland, S. L., Rubin, B. K.,\u00a0Drescher, G. S., Haas, C. F., O\u2019Malley, C. A.,\u00a0Volsko, T. A., ... Hess, D. R. (2013). <em>AARC clinical practice guideline: Effectiveness of nonpharmacologic airway clearance therapies in hospitalized patients<\/em>.\u00a0 <a href=\"https:\/\/www.aarc.org\/wp-content\/uploads\/2014\/08\/nonpharmacologic_2013.pdf\">https:\/\/www.aarc.org\/wp-content\/uploads\/2014\/08\/nonpharmacologic_2013.pdf<\/a>.","rendered":"<h2 style=\"text-align: center\"><strong>Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\n<ol>\n<li><strong>Explain how you might know if your patient is hypoxic or hypoxemic?<\/strong><\/li>\n<\/ol>\n<p><em>\u00a0<\/em><em>Answer: Hypoxia = arterial oxygen tension or partial pressure of oxygen PaO2 is below normal (&lt;80 mmHg) and is measured by ABGs.\u00a0 Hypoxemia = reduction of oxygen supply to the tissues and is measured by pulse oximetry SpO2. <\/em><em>A person can have hypoxemia but is compensating through increased HR \/ increasing oxygen supply.<\/em><\/p>\n<p>Sources: Alberta Health Services. (2015)<em>. Oxygen therapy for acute adult inpatients. Learning module for Allied Health staff (category 1 and 2). <\/em><em><a href=\"http:\/\/www.albertahealthservices.ca\/assets\/info\/hp\/edu\/if-hp-edu-ahc-oxygen-therapy-learning-module-cat-1and2.pdf\">http:\/\/www.albertahealthservices.ca\/assets\/info\/hp\/edu\/if-hp-edu-ahc-oxygen-therapy-learning-module-cat-1and2.pdf<\/a>.<\/em><\/p>\n<p>Considine, J. (2007). <em>Emergency assessment of oxygenation<\/em>.\u00a0 <a href=\"https:\/\/acutecaretesting.org\/en\/articles\/emergency-assessment-of-oxygenation\">https:\/\/acutecaretesting.org\/en\/articles\/emergency-assessment-of-oxygenation<\/a>.<\/p>\n<p>Fournier,\u00a0 M. (2014). Caring for patients in respiratory failure. <em>American Nurse Today<\/em>, <em>9<\/em>(11).\u00a0 <a href=\"https:\/\/www.americannursetoday.com\/caring-patients-respiratory-failure\/\">https:\/\/www.americannursetoday.com\/caring-patients-respiratory-failure\/<\/a><\/p>\n<ol start=\"2\">\n<li><strong>Why might the post surgical patient require supplemental oxygen?<\/strong><\/li>\n<\/ol>\n<p><em>\u00a0<\/em><em>Answer: Sedation from general anesthetics, sedatives, analgesics can cause \u2193respiratory rate \u2192inadequate ventilation = need for supplemental oxygen <\/em><em>AND<\/em><em> DB&amp;C exercises<\/em><\/p>\n<p><em>Source:\u00a0<\/em>Perry, A., Potter, P., Ostendorf, W. (2017). \u00a0<em>Clinical Skills and Techniques<\/em> (9th ed.) Elsevier; Mosby.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"textbox shaded\" style=\"text-align: center\"><strong>Sample Quiz Questions<\/strong><\/p>\n<ol>\n<li><strong>Hilde. Age 59. History of smoking for 59 years is one day post op open cholecystectomy. Which of the following statements correctly reflect the nurse\u2019s thinking when caring for her?<\/strong> Select all that apply.<\/li>\n<\/ol>\n<ul>\n<li>Hilde is at risk for atelectasis post op <em>Answer: true. Post operatively patients are at risk for atelectasis due to pain and guarding which can result in diminished breaths eventually leading to atelectasis.<\/em><\/li>\n<li>Pain management along with ambulation and deep breathing and coughing should be encouraged approximately q2h. <em>Answer: true. Pain management often improves the ability to deep breathe and cough and ambulate. Both of these will allow Hilde to take deep breaths, improve\u00a0 ventilation and reduce risk of atelectasis<\/em><\/li>\n<li>Lower than normal SpO2 is normal for Hilde. <em>Answer: true. Hilde has smoked for 59 years. She may or may not have a diagnosis of lung disease. We know persons with COPD are expected to have below normal Spo2. The nurse should encourage DB&amp;C, ambulation and consult the prescriber for oxygen orders and an acceptable SpO2 for Hilde. Generally for persons with COPD the SpO2 target range is 88-92% because of the lung changes associated with the disease.<\/em><\/li>\n<\/ul>\n<p>Source: Abdo, W., Heunks, L. (2012). Oxygen induced hypercapnia in COPD: myths and facts. <em>Critical Care, 16<\/em>(5).\u00a0 doi:\u00a0 <a href=\"https:\/\/dx.doi.org\/10.1186%2Fcc11475\" target=\"pmc_ext\" rel=\"noopener noreferrer\">10.1186\/cc11475<\/a><\/p>\n<ol start=\"2\">\n<li><strong>Use of Incentive inspirometry is an effective strategy to decrease risk of atelectasis and optimize oxygenation in the post op patient. True or False.<\/strong><\/li>\n<\/ol>\n<p><em>Answer: false. The evidence to support the use of routine use of incentive inspirometry to prevent post op respiratory complications is not strong.<\/em> <em>However ambulation, deep breathing and coughing are effective strategies and must be integrated along with effective pain management in order to reduce risk of respiratory related post op complications..<\/em><\/p>\n<p><em>\u00a0<\/em>Sources:<\/p>\n<p>Eltorai, A., Szabo et al. (2017 )Clinical Effectiveness of Incentive Spirometry for the Prevention of Postoperative Pulmonary Complications. <em>Respiratory Care<\/em>.\u00a0 DOI: 10.4187\/respcare.05679<\/p>\n<p>Strickland, S. L., Rubin, B. K.,\u00a0Drescher, G. S., Haas, C. F., O\u2019Malley, C. A.,\u00a0Volsko, T. A., &#8230; Hess, D. R. (2013). <em>AARC clinical practice guideline: Effectiveness of nonpharmacologic airway clearance therapies in hospitalized patients<\/em>.\u00a0 <a href=\"https:\/\/www.aarc.org\/wp-content\/uploads\/2014\/08\/nonpharmacologic_2013.pdf\">https:\/\/www.aarc.org\/wp-content\/uploads\/2014\/08\/nonpharmacologic_2013.pdf<\/a>.<\/p>\n","protected":false},"author":397,"menu_order":1,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-135","chapter","type-chapter","status-publish","hentry"],"part":132,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/users\/397"}],"version-history":[{"count":9,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/135\/revisions"}],"predecessor-version":[{"id":783,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/135\/revisions\/783"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/parts\/132"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/135\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/media?parent=135"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapter-type?post=135"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/contributor?post=135"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/license?post=135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}