O2 therapy - need Dr's order?

I have a post-op patient with impaired gas exchange. He is not doing TCDB, the pulse oximerty indicates his SaO2 is less than 90%. In ABG, PCO2 is high. He is somewhat cyanotic. Can a nurse start an O2 therapy, say with nasal cannula or whatever appropriate? Or do I need to call a Dr and get an order before staring O2 therapy?

I would put 2 liters on him and promptly call the doc...

start 2lnc while u page the md just in case the pt's co2 is high cuz of chronic copd just to cover urself, but in reality you'd be better off starting the 02 than using the excuse of a doctor not present to order the 02....if ur patient is going into impending resp failure then push the code blue button and bag the patient, then ur covered. just my thoughts

Start the oxygen, call the doctor, and why won't the patient TC&DB (can't or won't)?

start 2lnc while u page the md just in case the pt's co2 is high cuz of chronic copd just to cover urself, but in reality you'd be better off starting the 02 than using the excuse of a doctor not present to order the 02....if ur patient is going into impending resp failure then push the code blue button and bag the patient, then ur covered. just my thoughts

I am a nursing student. Help me understand, please. What do you mean by bag the patient? Thank you!

I am a nursing student. Help me understand, please. What do you mean by bag the patient? Thank you!

Use an ambu bag and manually breathe for them.

I agree with the two liters via NC while calling MD. Does he have an IS? -Andrea

How High is the co2, and how low is the sats? Is the patient alert and oriented? Starting 2l nc may make things worse with the copd, usually is not a problem to start o2 and then call the MD, it is tricky with copd pt.

How High is the co2, and how low is the sats? Is the patient alert and oriented? Starting 2l nc may make things worse with the copd, usually is not a problem to start o2 and then call the MD, it is tricky with copd pt.

PCO2 is 50 mmHg, SaO2 is 85%. It is an emphysema patient but still early stage. Pt is alert and oriented. I understand from reading the textbook that risk of pt stop breathing by giving too much O2, but isn't 2L NC safe since it is low? Should I call MD because he is an emphysema pt?

never be afraid to give 02 therapy for fear of co2 retention especially if pt is already cyanotic and symptomatic....you always have bipap and vent to fall back on.

PCO2 is 50 mmHg, SaO2 is 85%. It is an emphysema patient but still early stage. Pt is alert and oriented. I understand from reading the textbook that risk of pt stop breathing by giving too much O2, but isn't 2L NC safe since it is low? Should I call MD because he is an emphysema pt?

I usually start o2 at 2l/min, have CNA or family encourage Incentive Spirometer use, and call M.D. ASAP. I also ask for EKG as they might be having a silent M.I. 2l/min usually fairly safe for short term use, unless they get diaphoretic, and R's decrease. Basic M/S.

never be afraid to give 02 therapy for fear of co2 retention especially if pt is already cyanotic and symptomatic....you always have bipap and vent to fall back on.

Do not withhold O2 from a symptomatic patient. Yes, a person with a hypoxic drive might go into respiratory arrest (doesn't happen as often as you might think), but then you go ahead and ventilate them.

Also, check your unit's P&P book. Chances are there are standing orders to cover this situation and I'll bet they're a lot like the advice that's been given here. 2L O2 n/c, get v/s, and call doc. An EKG, as one poster mentioned, is an excellent idea as well.

In an airway emergency, we can administer o2 and then get an order for it.

O2 at 2 L BNC is pretty much standard even with your severe end stage COPD patients.