giving O2 per request?

[mursetudent25]

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....

[Pneumothorax, BSN, RN]

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]

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]

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]

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.

[moonriseRN]

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.

[moonriseRN]

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

[Double-Helix, BSN, RN]

If it's been a week and nobody has mentioned it to you, then nobody is going to mention it. It's likely that the patient had an order for oxygen and the nurse would have connected it if you didn't. Just use this as a learning opportunity for the future. Always check your orders before giving oxygen, and it the patient has COPD make sure you know what their baseline O2 sats are. Oxygen orders are usually written something like this: 'O2 1-2 liters via nasal cannula. Wean to keep Sats between 90-95%.' So it usually tells you where to aim with the patient's sats.

[classicdame, MSN, EdD]

well you have certainly learned a lot with this episode. I am glad you brought it to this forum

[Vespertinas]

I once had a RT explain to me how the whole hypoxic drive theory is half-bologna. I wish I could recall the details but something about how the patients can HANDLE the extra CO2 in their bloodstream (meaning, managing to maintain their LOC and their respiratory drive) and that sometimes increasing their SaO2 would be kinder than allowing them to stay at 88%.

I wish he could explain it again though.