Administering Oxygen Therapy to the Patient with an Artificial Airway
- Improves tissue oxygenation.
- There are several indications for oxygen therapy:
- Hypoxia/hypoxemia.
- Decreased cardiac output.
- Increased oxygen demand.
- Decreased oxygen carrying capacity.
- Increased myocardial workload.
- Procedures that may cause hypoxemia.
The device for delivery of oxygen should be chosen based the oxygen-delivery needs of the patient.
- Trach Collar
- T-piece
- 21% to 100% oxygen.
- Possibility for condensation to collect in tubing and drain into patient's airway upon turningtherefore, empty tubing frequently.
- Possibility that weight of T-piece can pull on tracheostomy
See Fig. 8.2B T-Piece
- Mechanical ventilator
- 21% to 100% oxygen delivery.
- Requires skilled personnel to manage (usually respiratory therapy).
- Possibility that condensation could collect in the tubing and drain into the patient's airway, especially during turningtherefore, frequent emptying of tubing condensation is indicated.
Relevant Nursing Diagnoses
- Impaired gas exchange related to disease process
Evaluation and Follow-Up Activities
- Assess the patient's:
- Oxygen saturation, and compare to baseline
- Quality and rate of respirations, and compare to baseline
- Vital signs, and compare to baseline
- Comfort level
Key Points for Reporting and Recording
- Assessment of the patient's respiratory status before initiation of oxygen therapy, including oxygen saturation and a description of respirations including rate.
- Type of oxygen-delivery method initiated.
- Time of initiation of oxygen-delivery method.
- Percentage of oxygen currently being given.
- Assessment of patient's respiratory status after initiation of oxygen therapy to include oxygen saturation and a description of respirations including rate.