1.

RESPONSES TO ALTERED VENTILATORY

FUNCTIONS; OXYGEN THERAPY NCM 118
Prof. Nicomedes & Gariando || Aug 18, 2021
Transcribers: Bartolata
Editors: Bon, Vista
BLOCK A

 The upper airway consists of the nasal cavity and the

pharynx. The throat transports both air and food. Air
OUTLINE enters the upper part of the pharynx (nasopharynx) and
1. Responses to Altered Ventilatory Functions History of ECG then passes behind the mouth through the oropharynx.
 Respiratory System
 Noninvasive Assessment of Oxygenation  Respiration-act of breathing:
 Invasive Assessment of Oxygenation  Inhaling. The act of breathing in oxygen.
 Determining Rhythm  Exhaling. The act of breathing out carbon dioxide.
2. Oxygen Therapy
 Nursing Responsibilities  The respiratory system is made up of the organs included
3. O2 Administration by Nasal Cannula/Mask in the exchange of oxygen and carbon dioxide. These are
Procedure the parts:
 Nose
Legend:  Mouth
Remember Lecturer Book PPT  Throat (pharynx)
☝  🕮   Voice box (larynx)
 Windpipe (trachea)
RESPONSES TO ALTERED VENTILATORY FUNCTIONS  Large airways (bronchi)
 Small airways (bronchioles)
Objectives  Lungs
 Briefly review the anatomy and physiology of the
respiratory system  The upper respiratory tract is made up of the:
 Describe methods for assessing the respiratory system  Nose
including physical assessment  Nasal cavity
 Interpretation of non-invasive techniques and arterial  Sinuses
blood gases  Larynx
 Describe different methods for assessing the respiratory  The lower respiratory tract is made up of the:
functions  Trachea
Respiratory System  Lungs
 Bronchi and bronchioles
 Air sacs (alveoli)

 Lungs
 The lungs take in oxygen. Your body's cells need oxygen
to live and carry out their normal functions. The lungs also
get rid of carbon dioxide, a waste product of the cells.
 The lungs are a pair of cone-shaped organs made up of
spongy, pinkish-gray tissue. They take up most of the
space in the chest (thorax).
 The lungs are surrounded by a membrane (pleura).
 The lungs are separated from each other by the
mediastinum, an area that contains the:
 Heart and its large vessels
 Trachea
 Esophagus
 Thymus gland
 Lymph nodes

 The right lung has 3 sections, called lobes. The left lung
 A sensor that measures SpO2 is placed on the finger,
has 2 lobes. When you breathe in:
  Air enters your body through your nose or mouth.
 Air then travels down the throat through the larynx
and trachea.
 Air goes into the lungs through tubes called main-
stem bronchi.
 One main-stem bronchus leads to the right lung and
one to the left lung:
 In the lungs, the main-stem bronchi divide into smaller
bronchi.
 The smaller bronchi divide into even smaller tubes
(bronchioles).
 Bronchioles end in tiny air sacs (alveoli) where the
exchange of oxygen and carbon dioxide occurs.
 You then breathe out carbon dioxide.
 GAS EXCHANGE. The process of gas exchange consists
of four steps:
1. VENTILATION-movement of gases in and out the
alveoli
2. DIFFUSION AT PULMONARY CAPILLARIES-
diffusion of O2 and CO2 at the pulmonary capillary
level
3. PERFUSION (Transportation)-the oxygenated blood
is perfused or transported to the tissues
4. DIFFUSION TO THE CELLS
ASSESSMENT
 Health history-tobacco use, occupational history, history
of shortness of breath, allergies, date of last x-ray, use of
inhalants like bronchodilators and steroids
 Physical examination-IPPA
 Breath sounds-adventitious breath sounds or abnormal
lung sounds like crackles, wheezing and pleural friction
rubs
 Health history-history of smoking, how many packs per
day, how many years; occupational history like exposure
to coal mining, asbestos or lead; hx of sputum production,
shortness of breath, weight loss, anorexia, or chest pain
NONINVASIVE ASSESSMENT OF OXYGENATION
Pulse oximetry is a test used to measure the oxygen level
(oxygen saturation) of the blood. It is an easy, painless
measure of how well oxygen is being sent to parts of your body
furthest from your heart, such as the arms and legs.
 It uses a light-emitting diodes to measure pulsatile flow
and light absorption of the hemoglobin
 Respiratory Alkalosis-
condition marked by a low level
of carbon dioxide in the blood
due to breathing excessively
 Respiratory acidosis-condition
that occurs when the lungs cannot remove all of the
carbon dioxide the body produces; this causes body fluids,
especially the blood to become too acidic (asthma, COPD,
toe, ear or forehead
 Accurate reading is obtained from well perfused areas
 Pulse oximetry values are used to monitor a patient’s
response to treatment (ventilator changes, weaning from
mechanical ventilator,suctioning)
 However, it only measures oxygenation, changes in
ventilation cannot be assessed with pulse oximetry
(carbon dioxide retention)
INVASIVE ASSESSMENT
1. ABG (ARTERIAL BLOOD GAS)
 The ability to interpret ABG results is an essential critical
care skill.
 ABG) test measures the acidity (pH) and the levels of
oxygen and carbon dioxide in the blood from an artery.
This test is used to find out how well your lungs are able
to move oxygen into the blood and remove carbon
dioxide from the blood.
 ABG results reflect oxygenation adequacy of gas
exchange in the lungs and acid –base status.
 Blood for ABG analysis in obtained from either a direct
arterial puncture (radial, brachial or femoral) or an arterial
line
 The ABG values that reflect oxygenation include the
PaO2, and the arterial oxygen saturation of the
hemoglobin (SaO2)
 PaO2 is the partial pressure of oxygen dissolved in
arterial blood. The normal PaO2 is 80 to 100 mmHg at
sea level.
 SaO2 refers to the amount of oxygen bound to
hemoglobin. The normal saturation of hemoglobin ranges
from 93% to 99%
 Decreased oxygenation of arterial blood
(PaO2<80mmHg) is referred to as hypoxemia
 It is different from hypoxia which is a decrease in oxygen
at the tissue level
Why Is an Arterial Blood Gas Test Done?
Your doctor may ask for an arterial blood gas test to:
 Check for severe breathing and lung problems such
as asthma, cystic fibrosis, or chronic obstructive
pulmonary disease (COPD)
 Check how treatments for your lung problems are working
 Check whether you need extra oxygen or other help with
breathing
 Check your acid-base balance. You can have too much
acid in your body from kidney failure, a severe infection,
specific toxic ingestions, complications of diabetes (DKA),
or under-treated sleep apnea.
 Your doctor or another health care worker will use a small
needle to take some of your blood, usually from your
wrist. Sometimes they take it from an artery in your groin
or on the inside of your arm above your elbow.
 Before the arterial blood gas test, they may apply
pressure to the arteries in your wrist for several seconds.
The procedure, called the modified Allen test, checks that
blood flow to your  hand  is normal.
 sleep apnea, airway edema)
 Metabolic alkalosis-defined as elevation of the body’s pH
above 7.45; involves a primary increase in sodium
bicarbonate concentration due to loss of H+ or hydrogen
ions from the body or gain of HCO
 Metabolic acidosis-condition wherein there is so much
acids in the body fluids (dehydration, liver failure, low
blood sugar)
2. PULMONARY WEDGE PRESSURE
The pulmonary wedge pressure or PWP, or cross-sectional
pressure (also called the pulmonary arterial wedge pressure or
PAWP, pulmonary capillary wedge pressure or PCWP, or
pulmonary artery occlusion pressure or PAOP), is the pressure
measured by wedging a pulmonary catheter with an inflated
balloon into a small pulmonary arterial branch. It estimates the
left atrial pressure.
lying on the table beneath the scanner arm. You do not need
to fast, eat a special diet, or take any medications before
the test.
What does high wedge pressure mean?
Pulmonary Capillary Wedge Pressure (PCWP or PAWP):
PCWP pressures are used to approximate LVEDP (left
ventricular end diastolic pressure).
High PCWP may indicate left ventricle failure, mitral valve
pathology, cardiac insufficiency, cardiac compression post
hemorrhage.
3. PLEURAL FLUID ANALYSIS
- examines fluid collected in pleural space
This is the space between the lining of the outside of the lungs
(pleura) and the wall of the chest.
When fluid collects in the pleural space, the condition is
called pleural effusion. 14 Oct 2019

What is the normal value of pleural fluid?

In healthy individuals, there is about 10-20 mm of pleural fluid
that is evenly distributed across the pleura and it is continually
replenished from the blood in the tiny blood vessels
(capillaries) in your lungs. Certain diseases will increase the
pleural volume, usually as a pocket or collection. 11 Aug 2020

4. PULMONARY ANGIOGRAPHY
What does a VQ scan diagnose?
A pulmonary angiogram is an angiogram of the blood vessels
A VQ scan can help to diagnose a blood clot in the lungs. If left
of the lungs. The procedure is done with a special contrast
untreated, blood clots can be fatal. If you have symptoms of a
dye injected into the body's blood vessels. This is done in the
blood clot, such as shortness of breath and a sharp pain when
groin or arm. The dye shows up on X-rays. Fluoroscopy is
you breathe in, your doctor might recommend a VQ scan. A
often used during this test.
blood clot is also known as a pulmonary embolism or PE.

How is ventilation perfusion scan done?

The ventilation scan is performed by scanning the lungs
while the person inhales radioactive gas. With a mask over
the nose and mouth, the patient breathes the gas while sitting
or
4. CAPNOGRAPHY
- non-invasive measurement during inspiration and expiration
of the partial pressure of CO2 from the airway; provides
physiologic information on ventilation, perfusion, and
What is pulmonary angiogram used for?
metabolism, which is important for airway management.
 The test is used to detect blood clots (pulmonary
embolism) and other blockages in the blood flow in
What is capnography used for?
the lung. Most of the time, your provider will have tried
- diagnose early respiratory depression & airway
other tests to diagnose a blood clot in the lungs.
disorders, especially during sedation, leading to a reduction in
 Pulmonary angiography may also be used to help
serious complications; provided more safety in monitoring
diagnose: AV malformations of the lung.30 Oct 2020
patients during sedation. 15 Jan 2018

Indications
4. VENTILATION-PERFUSION SCAN
 evaluation of maximum exhaled CO2 concentration as
a reflection of the PaCO. A pulmonary ventilation/perfusion scan is a pair of nuclear
scan tests. These tests use inhaled and injected radioactive
 evaluation of the severity of pulmonary disease.
material (radioisotopes) to measure breathing (ventilation) and
 monitoring the integrity of the ventilator circuit and
circulation (perfusion) in all areas of the lungs.
PRAGMATIC
 artificial airway.
 monitoring the adequacy of pulmonary blood flow.
Normal range
 35 to 45 mmHg
 rate of ventilation should be 12-20 breaths per minute
(bpm) for adults if the patient is breathing on their own
and 10-12 bpm if you're ventilating them.
References
 Introduction to Critical Care Nursing, Ed 3; Sole, Lamborn
and Harthorn, W.B. Saunders Company
 Health Assessment Made Incredibly Visual, Lippincott
Williams and Wilkins
 https://www.google.com/search?
q=pulse+oximetry&sxsrf=ALeKk00Q-
Qne_Pth5V5COKWB08gD7jNcng
%3A1628956929432&ei=AekXYffdGciFoATkjoHQB
 https://www.google.com/search?q=ventilation-
perfusion+scan&sxsrf=ALeKk01ulIizd_vQf_MuCD_xMJYP
eZmPbw%3A1629014298908
 Hypercapnia: Increased amounts of carbon dioxide in the
blood.
 Hypoxemia: Low arterial oxygen tension (in the blood.)
 Hypoxia: Low oxygen level at the tissues.
 Low flow: Low flow systems are specific devices that do
not provide the patient's entire ventilatory requirements,
room air is entrained with the oxygen, diluting the FiO2.
☝ Review of Normal Values and SpO2 Targets
 Partial pressure of arterial oxygen (PaO2)
o 80 -100 mmHg - children/adults
o 50 - 80 mmHg - neonates
 Partial pressure of arterial CO2 (PaCO2)
o 35 - 45 mmHg children/adults
o pH = 7.35 -7.45
OXYGEN THERAPY
Learning Outcomes
 Discuss methods of administering Oxygen Therapy
commonly practice in the local health facility settings.
 Video Presentation of 2 common methods of
administering Oxygen in the local health facility.
Equipment
 The equipment needed depends on the type of delivery
system ordered.
 Equipment includes selections from the following list:
 Oxygen source (wall unit, cylinder, liquid tank, or
concentrator)
 flowmeter
 adapter, if using a wall unit or a pressure-reduction
gauge, if using a cylinder
 sterile humidity bottle and adapters
 sterile distilled water
 oxygen precaution sign (No Smoking)
 appropriate oxygen delivery system (a nasal cannula,
simple mask, or nonrebreather mask for low-flow and
variable oxygen concentrations; a Venturi mask, gloves
 stethoscope
 sphygmomanometer
☝ Definition of Terms
 FiO2: Fraction of inspired oxygen (%).
 PaCO2: The partial pressure of CO2 in arterial blood. It is
used to assess the adequacy of ventilation.
 PaO2: The partial pressure of oxygen in arterial blood. It
is used to assess the adequacy of oxygenation.
 SaO2: Arterial oxygen saturation measured from blood
specimen.
 SpO2: Arterial oxygen saturation measured via pulse
oximetry.
 High flow: High flow systems are specific devices that
deliver the patient's entire ventilatory demand, meeting,
or exceeding the patients Peak Inspiratory Flow Rate
(PIFR), thereby providing an accurate FiO2.
 Humidification is the addition of heat and moisture to a
gas. The amount of water vapor that a gas can carry
increases with temperature.
☝ Review of SpO2 Targets
 94% - 98% (PaO2 between 80 and 100 mmHg) in patients
without cyanotic congenital heart disease or chronic lung
disease
 > 70% (PaO2 37 mmHg) in patients who have had cardiac
surgery of their congenital cyanotic heart disease
 > 60% (PaO2 32mmHg) in unrepaired congenital cyanotic
heart disease
 91 - 95% for premature and term neonates
 ≥ 90% for infants with bronchiolitis
INTRODUCTION
Oxygen is required by all tissues to support cell
metabolism; in acute illness, low tissue oxygenation (hypoxia)
can occur due to a failure in any of the systems that deliver
and circulate oxygen. Hypoxia is an indication to start oxygen
therapy; this can be a lifesaving intervention, but given without
appropriate assessment and ongoing evaluation, it can also be
detrimental to patient’s health. (Ridler et al, 2014.)
The guidelines recommend:
 administering oxygen to treat hypoxemia (low blood
oxygen levels)
 prescribing a target oxygen saturation range to guide
therapeutic treatment.
In an emergency situation, immediate assessment of
airway patency, breathing and circulation is essential, and in
critical illness such as peri-arrest, high concentration oxygen
should be commenced via reservoir mask at 10-15L/min. if the
patient is hypoxic, with continuous monitoring of pulse oximetry
and prescription of an appropriate target range once the
patient’s condition is stabilized (Resuscitation Council (UK),
2015).
Pulse Oximetry must be available in all settings where
emergency oxygen is used. It is essential to:
 record Inspired oxygen (FIO2) delivery device and oxygen
saturation.
 monitor and document the effect of any changes to
administer O2 therapy.
3. NONREBREATHER MASK
On inhalation, the one-way valve opens, directing oxygen from
a reservoir bag into the mask. On exhalation, gas exits the
mask through the one-way expiratory valve and enters the
atmosphere. The patient only breathes gas from the bag.
Advantages:  chin, and mold the flexible metal edge to the bridge of the
Delivers the highest
possible oxygen
concentration (60% to
90%) short of intubation
and mechanical
ventilation; effective for
short-term therapy; can
be converted to a partial
rebreather mask, if
necessary, by removing
What are the common various oxygen therapy devices?
1. NASAL CANNULA
Oxygen is delivered through plastic
cannulas in the patient’s nostrils.
Advantages: Safe and simple; comfortable and easily
tolerated; nasal prongs can be shaped to fit any face; effective
for low oxygen concentrations; allows movement, eating, and
talking; inexpensive and disposable.
Disadvantages: Can’t deliver concentrations higher than 40%;
can’t be used in complete nasal obstruction; may cause
headaches or dry mucous membranes if flow rate exceeds 6
L/minute; can dislodge easily.
Administration guidelines: 
Hook the cannula tubing behind the patient’s ears and under
the chin. Slide the adjuster upward under the chin to secure
the tubing. If using an elastic strap to secure the cannula,
position it over the ears and around the back of the head.
Avoid applying it too tightly, which can result in excess
pressure on facial structures and cannula occlusion as well.
With a nasal cannula, oral breathers achieve the same
oxygen delivery as nasal breathers.
2. SIMPLE MASK
Oxygen flows through an entry port at the bottom of the mask
and exits through large holes on the sides of the mask.
Advantages: Can deliver
concentrations of 35% to
50%.
Disadvantages: Hot and
confining; may irritate
patient’s skin; tight seal,
which may cause
discomfort, is required
for higher oxygen
concentration; interferes
with talking and eating;
impractical for long-term
therapy because of
imprecision.
Administration guidelines: Select the mask size that offers the
best fit. Place the mask over the patient’s nose, mouth, and
nose. Adjust the elastic band around the head to hold the
mask firmly but comfortably over the cheeks, chin, and bridge
of the nose. For elderly or cachectic patients with sunken
cheeks, tape gauze pads to the mask over the cheek area to
try to create an airtight seal. Without this seal, room air dilutes
the oxygen, preventing delivery of the prescribed
concentration. A minimum of 5 L/minute is required in all
masks to flush expired carbon dioxide from the mask so that
the patient doesn’t rebreathe it.
the one-way valve.
Disadvantages: 
Requires a tight seal, which may be difficult to maintain and
may cause discomfort; may irritate the patient’s skin; interferes
with talking and eating; impractical for long-term therapy.
Administration guidelines: Follow procedures listed for the
simple mask. Make sure that the mask fits very snugly and that
the one-way valves are secure and functioning. Because the
mask excludes room air, valve malfunction can cause carbon
dioxide buildup and suffocate an unconscious patient. If the
reservoir bag collapses more than slightly during inspiration,
raise the flow rate until you see only a slight deflation. Marked
or complete deflation indicates an insufficient flow rate. Keep
the reservoir bag from twisting or kinking. Ensure free
expansion by making sure the bag lies outside the patient’s
gown and bedcovers.
4. VENTURI / AIR-ENTRAINMENT MASK
 mixes oxygen with room air, creating high-flow enriched
oxygen of a desired concentration. It provides an accurate
and constant FiO2 despite varied respiratory rates and
tidal volumes. FiO2 delivery settings are typically set at 24,
28, 31, 35 and 40% oxygen.
 This device is appropriate for patients who have a hypoxic
drive to breathe but also need supplemental oxygen; ex.
COPD pt..
Recommended Vids
 https://youtu.be/DNx_WoNjs2U
 https://youtu.be/WZRuOsJuYTY
 https://youtu.be/8ceP-iVHEPA
References
 Citation: Olive S (2016) Practical Procedures: oxygen
therapy. Nursing times; 112:1/2, 12-14. Author: Sandra
Olive, respiratory nurse specialist, Norfolk and Norwich
University Hospitals Foundation Trust.
 Clinical Guidelines (Nursing): Oxygen delivery
 https://www.rch.org.au › hospital_clinical_guideline_index
NURSING RESPONSIBILITIES
 Relieve hypoxemia and maintain adequate oxygenation
of tissues and vital organs, as assessed by
SpO2 /SaO2 monitoring and clinical signs.
 Give oxygen therapy in a way which prevents excessive
CO2 accumulation - i.e. selection of the appropriate flow
rate and delivery device.
 Reduce the work of breathing.
General instructions to patients for oxygen therapy
 To help yourself
 Using oxygen may dry out your nose or lips
 If you use a nasal cannula, the tubing may rub under your
nostrils and around your ears
 Do not use alcohol or take drugs that relax you, because
they will slow your breathing rate
 Keep track of how much oxygen is in the tank, and
reorder before it runs out
What should you check before administering oxygen?
 Document baseline observations including saturations,
respiratory rate, blood pressure and pulse.
 Note respiratory effort, color, level of consciousness.
 Check that there is a prescription for oxygen with a stated
target saturation range (except in peri-arrest situation)
 Medical emergencies requiring high concentrations of
oxygen in all cases: Shock. Sepsis. Major trauma.
Cardiac arrest and during resuscitation. Anaphylaxis. ...
 Medical emergencies which may or may not require
oxygen administration. Asthma. Bronchitis. Acute heart
failure or heart failure exacerbations. Pulmonary
embolism.
When should oxygen therapy be administered?
 Oxygen is indicated for all breathless patients.
 Oxygen is indicated in a patient who is suffering an acute
MI who has saturation of 90%.
 Oxygen should be given to all patients having an acute
stroke regardless of oxygen saturation.

• Fit the mask to the contours of the client’s face
• Secure the elastic band around the client’s head so that
the mask is comfortable but snug.
• Pad the band behind the ears and over bony
prominences.
11. Assess the client regularly.
• Assess the client’s vital signs, level of anxiety, color, and
ease of respirations, and provide support while the client
adjusts to the device.
• Assess the client in 15 to 30 minutes, depending on the
client’s condition, and regularly thereafter for any signs of
hypoxia, tachycardia, dyspnea, restlessness and cyanosis.
12. Monitor continuous therapy by assessing for pressure
areas on the skin and nares every 2 hours and rechecking
flow rate every 4 to 8 hours.
13. For nasal cannula
• When using a nasal cannula, place the prongs into the
patient’s nares and fit the tubing around their ears.
• Apply a water-soluble lubricant as required to soothe the
Nasal mucous membranes.
• Place gauze pads at ear beneath the tubing, as
necessary.
O2 ADMINISTRATION BY NASAL CANNULA/MASK
Procedure
Preparation
1. Determine the need for oxygen therapy, and verify the
medical order for the therapy.
a. Confirm patient ID using two patient identifiers (e.g., name
and date of birth).
2. Prepare the client and support people
• Assist the client to a semi-Fowler’s position if possible
• Explain that oxygen is not dangerous when safety
precautions are observed.
• Inform the client and support people about the safety
precautions connected with oxygen use.
Performance
3. Introduce self and verify the client’s identity using agency
protocol. Explain to the client what you are going to do, why it
is necessary, and how he or she can participate.
4. Discuss how the effects of the oxygen therapy will be used
in planning further care or treatments
5. Explain that oxygen will ease dyspnea or discomfort.
Encourage him/her to breathe through the nose.
6. Perform hand hygiene and observe other appropriate
infection prevention procedures
7. Provide for client privacy, if appropriate
8. Set up the oxygen equipment and the humidifier
• Attach the flow meter to the wall outlet or tank. The flow
meter should be in the off position.
• If needed, fill the humidifier bottle. (This can be done
before coming to the bedside.).
• Attach the humidifier bottle to the base of the flow
meter.
• Attach the prescribed oxygen tubing and delivery device
to the humidifier
9. Turn on the oxygen at the prescribed rate and ensure
proper functioning.
• Check that the oxygen is flowing freely through the
tubing.
• There should be no kinks in the tubing, and the
connections should be airtight
• There should be bubbles in the humidifier
as the oxygen flows through.
You should feel the oxygen at the outlets of the cannula
or mask
• Set the oxygen at the flow rate ordered.
10. Apply the appropriate oxygen delivery device.
Cannula
• Place the tips of the cannula no more than 1.25 cm to
the patient’s nares.
• Put the cannula over the client’s face, with the outlet
prongs fitting into the nares and the tubing hooked
around the ears.
• If the cannula will not stay in place, tape it at the sides
of the face
• Pad the tubing and band over the ears and cheekbones
as needed.
Face Mask
• Guide the mask toward the client’s face, and apply it
For face mask
from the nose downward
• When using a mask, place the mask over the patient’s
Sample Documentation:
mouth and nose, secure a firm seal, and tighten the straps
P: Impaired gas exchange.
around the head
I: O2 at 2L/m via cannula started because sats dropped to
• Inspect the facial skin frequently for dampness or
91%. RR 26 and c/o dyspnea. Teaching regarding the
chafing, and dry and treat it as needed.
importance of O2 and reinforced the importance of deep
breathing.
Reservoir mask (non-rebreathing mask)
E: O2 sats increased to 94%, RR 18, states more
• If using a non-rebreather mask, partially inflate the
comfortable. (your name and signature)
reservoir bag before applying the mask. Place the patient
in an upright position as clinically appropriate.

14. Inspect the equipment on a regular basis.

• Check the liter flow and the level of water in the
humidifier in 30 minutes and whenever providing care to
the client.
• Make sure that safety precautions are being followed.
o CALL LIGHT: Within reach
o BED: Low and locked (in lowest position and brakes
on)
o SIDE RAILS: Secured
o TABLE: Within reach
o ROOM: Risk-free for falls (scan room and clear any
obstacles)
15. Remove PPE, if used. Perform hand hygiene
16. DOCUMENT PROCEDURE:
- O2 liter flow, and
- assessment of client response to treatment.
In patient’s record.
17. Evaluate patient’s response to oxygen therapy including
airway, respiratory rate, pulse oximetry reading, and reported
dyspnea.