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giving O2 per request?

Posted

If a patient asks you to connect their breathing tube device to the O2 fossett and put on the oxygen level to 1L is it fine to do so or should i be notifying the nurse? That's exactly what I did for a patient with COPD and a ~90% sat...noone mentioned anything to me about it but was it the right thing to do since putting up the oxygen on high could actually do damage....

Staragate, ADN, ASN, RN

Specializes in Dialysis. Has 5 years experience.

I'm a student too. The answer is no, unless the oxygen is already set up in her room with a cannula and everything. She was satting low, but COPD patients depend on a certain amount of oxygen deprivation to stimulate the instinct to breathe. The rest of us depend on our carbon dioxide levels. If the O2 goes too high, she can stop breathing.

Now that I scared you, oxygen is probably appropriate for this patient. Oxygen is controlled like any other medication, so it needs an order within 2 hours I believe. (RNs, correct me if I'm wrong!)

Anyway, check with your nurse/instructor if in doubt.

yea the cannula was there, she asked me to connect it to the fossett and put it on 1L...which is what I did..but then today i found out that that could be pretty dangerous...noone mentioned anything to me about it (this happened last week)...i didnt do anything wrong i hope

Staragate, ADN, ASN, RN

Specializes in Dialysis. Has 5 years experience.

Just remember, don't do anything you weren't trained on. Ask if you don't know. I wouldn't touch oxygen as a CNA until they showed me how everything worked. If they are on O2 on a wheel chair tank, then the rate has to match on the wall when I transfer them from their chair to the bed, for example.

Oxygen is a medication and requires a doctor's order like any other med. You didn't do anything wrong if - there was a doctor's order (or other standing order) for O2, if you are allowed in your clinical setting to give the O2 and you documented it properly.

Generally UAP (in most states at least) are not allowed to adjust oxygen because it is a medication. So, if you were at your job as a CNA or other UAP, you probably should not have adjusted the O2.

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative.

Not only do you need an order for the O2 but you ned to assess whether or not the pt needs the O2. You can't just turn it on just because they ask for it.You need to assess their O2 sats.

Not only do you need an order for the O2 but you ned to assess whether or not the pt needs the O2. You can't just turn it on just because they ask for it.You need to assess their O2 sats.

not good..i assume nothing bad came of this, but i did not know oxygen is a medication...

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU. Has 10 years experience.

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Edited by Double-Helix
Double posted

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU. Has 10 years experience.

Did you have an order for nasal cannula at 1lpm? If not, then you should not turn on the oxygen- especially in a patient with COPD. In a healthy person, there simulua to breathe comes from a build up of CO2. In a person with COPD, their stimulus to breathe is low O2. They have lower than normal sats all the time. If you give them oxygen and their O2 sats get too high, they can stop breathing. Why was she asking for the oxygen and why was it off? Was she short of breath? We're her sats lower than normal? Did you check with the primary nurse? You need to be very careful with oxygen in patients with COPD and never give any medication, including oxygen, without an order.

Did you have an order for nasal cannula at 1lpm? If not, then you should not turn on the oxygen- especially in a patient with COPD. In a healthy person, there simulua to breathe comes from a build up of CO2. In a person with COPD, their stimulus to breathe is low O2. They have lower than normal sats all the time. If you give them oxygen and their O2 sats

I didn't even check, the patient just asked me to connect the cannula to the wall O2 and put it onto 1L since they were short of breath, I had no clue this was a medication...I thought it was just an intervention..the patient did have an O2 tank on wheels, I guess they could have turned it on themselves anyhow? weird that noone has mentioned anything to me about it...and i did write about it on the daily reflection........uhoh

Pneumothorax, BSN, RN

Specializes in Critical Care, Emergency Medicine, Flight.

ya someone with COPD can have complications if they get to much oxygen, however if u put the NC on at 1/lpm and walked away its not going to kill them. it take a little bit of time

O2 is a medication.

Now, on the issue of asking for a doc order. In a COPD pt with 90% sats thats pretty good, and you could have told them.. hey ill be right back i need to go call the doctor or whatever about connecting you to the oxygen.

If you had a pt who has activity intolerance with 87% sats bc you ambulated them and they are huffing and puffing. You can put 2L/nc on them to raise their sats WHILE you are going to get ur primary or whoever to get the order for 02.

thanks

what happened was the patient was short of breath and asked me to connect the cannula to the wall and put the oxygen onto 1L, so i did that then monitored the oxygen level (it got to 95%), i didnt notify anyone of anything since i figured they were going to connect to the oxygen anyhow and I was just helping out..big mistake i guess...i hope this doesnt go under medication error or passing meds without order....uhoh

Pneumothorax, BSN, RN

Specializes in Critical Care, Emergency Medicine, Flight.

thanks

what happened was the patient was short of breath and asked me to connect the cannula to the wall and put the oxygen onto 1L, so i did that then monitored the oxygen level (it got to 95%), i didnt notify anyone of anything since i figured they were going to connect to the oxygen anyhow and I was just helping out..big mistake i guess...i hope this doesnt go under medication error or passing meds without order....uhoh

not likely.

ckh23, BSN, RN

Specializes in ER/ICU/STICU. Has 6 years experience.

Consider it a learning lesson. Some COPDers are O2 dependent and some use oxygen at home PRN such as when doing ADLs.

Creamsoda, ASN, RN

Specializes in ICU.

Are you a CNA or nursing student? I guess it doesn't really matter what you are. You are not a nurse. So if you are going to apply the oxygen, all you needed to do was tell your nurse in that situation. The key here is communication.

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg. Has 16 years experience.

O2 Is a drug. At least that's the way we treat it at the hospital where I work.

You should have checked the chart for an order. Or at least checked with the pt's nurse.

The bigger picture is there was a change in the pt's condition.

The pt wasn't SOB. Then the pt was SOB. What precipitated the change?

Just a walk to the BR? Repositioning in bed? Prolonged coughing?

It's a really bad idea to follow the orders of the pt instead of the MD.

Sometimes patients don't tell the truth.

COPD usually have an O2sat range from 85-90% but each patient will have differences.

As a student, the best thing is to 1) observe your patient to see if there are any signs of cyanosis, respirations, etc. 2) check to see if there is an order 3) get your professor if it is something that needs to be taken care of.

Oxygen is a medication and you can get oxygen toxicity - especially COPD patients.

We all make mistakes so it was good that you questioned yourself and now you will know!! Hopefully this was mentioned to your professor so if it was not supposed to be there - it would be removed and the right actions were implemented.

Oh yea, and you can always raise the HOB to a Fowler's position!