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Discussion

Confusing o2 orders. Help!

Hello, fellow lovely nurses. Thank you for all you do.

I work in a school setting and one of my students has a PRN order for oxygen, but I'm a little confused by it. It goes: "o2 PRN via nasal cannula 0.5 LPM for pao2 93 % or above. 1 LPM for pa02 below 93%."

So when do I administer it? My pt shows no s/s of respiratory distress but it seems like the order is saying that they still need o2 even if pao2 is WNL. Do I just watch for signs of respiratory distress or hypoxia? I tried calling the DR office a few times for clarification, but no one has been able to get back to me.

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    • Experts

    Send a written request for clarification of the order. If nothing else, type out the request on plain paper and include a supplemental physician's order form with the identifying data filled in.

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    • Experts

    Yea, that doesn't make sense. Unless they are on continuous O2 at home.

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    Am I reading correctly that the order references the partial pressure of arterial O2? I seriously doubt that you are monitoring paO2 outside the hospital setting.

    While you're getting clarification, you might want to ask that the order be written to reflect O2 saturation.

    I agree that you need to speak to the provider, but in the meantime, what can the parents tell you?

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    • Experts

    Jolie and I are thinking the same thing. The order is meaningless as written. It should read "SPO2" in the first place, and in the second place, are there orders for continuous oximetry, or are you just spot-checking? I totally see why you're confused!

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