Chapter 28
Respiratory Care
581
Skill 28.5 (continued) • Simple, rebreathing, and nonrebreathing masks: Place the mask over the patient’s nose and mouth and the elas- tic strip around the head, above the ears. Pull the strap at the sides of the mask to tighten so that the mask fits snugly over the face. Bend the metal nosepiece to conform to the bridge of the nose.
• Face tent: Fit the tent under the patient’s chin with the elas- tic strap around the head. Tighten at sides as needed for a snug chin fit.
• Tracheostomy collar: Place the collar loosely over the tra- cheostomy tube with the elastic strap around the patient’s neck. Tighten at the sides as needed to keep the collar in place. • T-piece: Attach to the tracheostomy tube and ensure that it is arranged so that any condensation within the tubing drains away from the patient. 8. Follow the Ending Implementation Steps located on the inside back cover. Evaluation Steps 1. Ensure that oxygen is flowing through the delivery device. There should be bubbles in the humidifier, indicating the flow of oxygen through it. To check low liter flow through an unhumidified cannula, place the cannula in a cup of water. If you see bubbles, the oxygen is flowing. 2. Measure pulse oximetry after 30 minutes to evaluate improvement of SaO 2 as a result of supplemental oxygen. 3. Evaluate the patient’s comfort with oxygen. Do they complain of feeling claustrophobic? Are they mouth-breathing? It may be necessary to consider a change of delivery device with the health-care provider’s approval.
• Venturi mask: Ensure that the dial or interchangeable valve between the mask and the oxygen source is correct to deliver the ordered percentage of oxygen. Apply the mask the same as the other masks.
Adjustable nose clip
Oxygen regulator Venturi barrel
Sample Documentation
10/10/28 1440 SaO 2 on room air was 90%. O 2 started per order at 2L/NC. _____________________________________________________________________________________ ___________________________________________________ Nurse’s signature and credentials
10/10/28 1520 SaO 2 94%. Tolerating cannula without c/o discomfort. States, “easier to breathe now.” ______________________________ ___________________________________________________ Nurse’s signature and credentials
(skill continues on page 582)
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