Oxygen therapy / high school (nurse)


 * Oxygen is an elemental gas essential for life.
 * Oxygen therapy means administering oxygen at a higher concentration than in atmospheric air (contains 21% O2, 78% nitrogen, 1% other gases)
 * Oxygen therapy is a treatment method that increases the supply to the tissues and organs of a patient who has preserved spontaneous breathing.
 * Tissue oxygen supply depends on ventilation, blood gas exchange, and circulatory distribution.

Methods of humidification of the airways
Under normal (physiological) conditions, the upper respiratory tract humidifies and heats the inhaled air, at pat. at APV, this is completely eliminated and therefore it is necessary to fully replace this function, the aim is to heat the inhaled mixture to a temperature of 30 ° C and humidify it to 70–100% humidity.


 * Active humidification - the mixture flows through the chamber system, where it is heated and moistened with sterile water.


 * the advantage is high-quality heating and humidification of the inhaled mixture, not increasing the dead space.
 * the disadvantage is ↑ the risk of multiplication of microorganisms in the water charge and in the condensation vessels


 * Passive humidification - a humidity and heat exchanger (HME filter) is included in the circuit, it acts as an antibacterial screen, the efficiency of humidification depends on the type of filter and the size of the breath. volume.


 * advantages: easy handling, lower costs, lower risk of infection.
 * Disadvantages: larger dead space, higher resistance in AW, risk of mucus obstruction, risk of insufficient heating and humidification.


 * Another type of humidifier is the so-called artificial nose - use for spontaneously ventilating for a short time (transport), or for outpatients who have a TS cannula.

Drugs affecting the respiratory tract

 * Bronchodilators - reduce obstruction in chronic diseases ( asthma, chronic bronchitis ), highly effective (Aminophylline, Theophylline).
 * Beta-mimetics - their effect is bronchodilation (bronchodilation) in bronchial asthma (where isoprenaline, adrenaline, ephedrine). Preferred use is the use of beta-mimetics with a selective (exclusive) effect on the bronchial system without affecting the heart muscle (Berotec, Ventolin, Brycanyl, Astmopent).


 * Parasympatholytic drugs, anticholinergics - to widen the bronchi, have a similar effect as beta-mimetics, only they have a slower onset and a smaller bronchodilator effect. They are indicated for resistance to beta-mimetics and corticoids, for chronic therapy with beta-blockers (Atrovent, Berodual (aerosols)).


 * Glucocorticoids - anti-inflammatory, anti-allergic, relaxing effect on bronchial smooth muscle, indicated for allergic conditions (asthma, anaphylactic shock, allergic skin diseases) and rheumatic diseases (Hydrocortisone, Solu-Medrol, Aldecin aerosol, Pulmicort).
 * Antitussives - suppresses the cough reflex (Codeine, Silomat, Sinecod, Intussin).
 * Expectorants, Mucolytics - facilitate coughing up mucus, reduce sputum viscosity (Ipecarin, Pleumolysin, Bromhexine, Mucosolvan, Mistabron, Ambrobene).
 * Respiratory stimulants - increase sensitivity to hypoxemia (Caffeine).
 * Surfactants - affect the surface tension of the alveoli, administered to the ETR (in children).

Preparing a patient / client in a hyperbaric chamber

 * They must not carry lighters, matches, cigarettes, flammable materials.
 * Only pure cotton clothing.
 * They must not use oils, creams, ointments.
 * Learn to use maneuvers to balance pressures.


 * Valsalv´s m. (Exhalation against a closed nose).
 * Toynbee´s m. (swallow).

Air-filled chamber:


 * Patients can keep their watches and jewelry.
 * They can take books, magazines, crossword puzzles with a pencil.
 * Wounds can be treated with a damp or greasy dressing, only it should be covered with a cotton bandage.
 * No restrictions on splints or plaster fixations.
 * A foam blanket can be used.

Oxygen filled chamber:


 * Metals, jewelry, books, magazines, prostheses, contact lenses must not be present.
 * Do not use damp or greasy coatings, ointments.
 * All splints, orthoses, prostheses must be removed.
 * Foams, disposable mats, pulp, larises must not be used.
 * Redon's drain must not be introduced.

Unconscious patient / client:


 * Before using HBO paracentesis.
 * Collection bags connected via anti-reflux valve.
 * Obturation balloons OTI, TS filled with fluid - AQ.
 * Infusion bottles must not be glass.
 * HD - we do not prevent air penetration.

Nursing diagnosis

 * Restlessness due to the need to use O2 treatment and limited mobility, manifested by motor restlessness and non-cooperation.


 * Goal: calm, oriented patient.
 * Intervention:
 * Listen to concerns, wishes and problems…
 * Ensure patient safety, avoid the possibility of falling out of bed.
 * Provide a comfortable position that improves patient ventilation.
 * Choose an alternative aid for the application of O 2 - according to the condition and in agreement with the doctor, inform the doctor and apply sedatives.
 * Avoid pulling out invasive inputs and the risk of self-harm.
 * Risk of AW damage and infection due to invasive AW ET cannulation.


 * Objective: no damage and development of AW infection.
 * Intervention:
 * Perform a regular and gentle AW toilet under aseptic conditions, use disposable aids and a closed exhaust system.
 * Check heating and humidification of the inhaled mixture.
 * Give mucolytics, expectorants (by inhalation) according to the surgery.
 * Perform regular changes of breathing circuits, filters, closed suction system, remove precipitated water from condensation vessels…
 * Deficiency of knowledge in connection with the administration of oxygen treatment due to the first hospitalization, manifested by fear and anxiety.


 * Goal: informed and calm patient.
 * Intervention:
 * Find out to what extent pat. informed of the need for O 2 treatment.
 * Talk, calm down and inform pat. on the importance of O 2 treatment.
 * Secure the signaling device close to the pat.
 * Be empathetic.

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