Fire is a significant hazard where oxygen is used. Do not permit flames, sparks, or smoking.
Oxygen delivery systems are categorized as low-flow (variable performance) systems or high-flow (fixed performance) systems. With low-flow systems, 100% oxygen mixes with room air during inspiration, and room air is entrained, making the percentage of delivered oxygen variable. High-flow devices provide such a high flow of premixed gas that the patient is not required to inhale room air.
Many patients in home care with ongoing oxygen needs have a plan in place for increasing oxygen requirements in times of illness and stress. The nurse should be aware of this plan and how to administer oxygen when there are signs of the need for increased oxygen consumption.
A variety of oxygen delivery devices are used in home care. A patients may have more than one device depending on his or her need and condition. A nasal cannula, oxygen mask (e.g., simple face mask, partial rebreather mask with reservoir, a nonrebreather mask with reservoir, Venturi mask), face tent, and oxygen hood deliver supplemental oxygen to children to treat hypoxia, respiratory distress, and respiratory failure (Table 1) (Table 2) (Table 3).undefined#ref1">1 Because oxygen can dry the respiratory system for flow rates over 1 L/min humidification should be provided.3
Home oxygen equipment is designated as durable medical equipment in the home health setting. Home oxygen therapy must be prescribed. Pulse oximetry measurement should be available in the home as it is the most common method of monitoring pediatric patients on home oxygen therapy.3
Report increased work of breathing, agitation, anxiety, altered mental status, changes in oxygen saturation, and changes in peripheral perfusion.
Rationale: The bridge of the nose and the cheeks are prone to skin breakdown.
Rationale: Dry and sore mucous membranes can develop with the delivery of oxygen.
Rationale: Oxygen can dry the respiratory system, resulting in thick secretions that are more difficult to mobilize. Dry air can lead to breakdown of the nasal mucosa, resulting in nosebleeds.
Wang, K.K-W. and others. (2016). Primary caregivers of in-home oxygen-dependent children: Predictors of stress based on characteristics, needs and social support. Journal of Advanced Nursing, 72(7), 1592-1601. doi:10.1111/jan.12934
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