Oxygen too high for COPD patient?

[Dani95rn]

Hi everyone it's my first post here. I started my first nursing job a couple of months ago after graduating in May. I'm on orientation and made a mistake regarding oxygen delivery to a patient. I had a COPD patient using her BiPap at night. I gave a nebulizer treatment and attached it to her BiPap mask and connected it to the wall oxygen. Now I know BiPap delivers a certain amount of oxygen in itself. I turned the nebulizer treatment up to about 5 lpm so she was getting the oxygen from nebulizer plus BiPap. I became busy and returned hours later to find that I kept the nebulizer with the oxygen connected to the mask still going. I'm worried I gave her too much oxygen. Patient was alert and fine. Another nurse told me the BiPap would help prevent any side effects of too much oxygen? I don't know if this is true or not. I feel so dumb!!

[Kitiger, RN]

BiPAP does not automatically deliver oxygen. Not everyone who needs support with ventilation will also need supplemental oxygenation. The oxygen must be specifically ordered.

Is oxygen specifically ordered with the nebulizer treatment? If not, it should be given with compressed air.

[ruby_jane, BSN, RN]

Welcome to nursing and to this community. You'll get more advice from folks who are now working on the floor, but I wanted to tell you that 1) we all make mistakes; 2) your mistake was simply not doubling back to recheck after a medication was given - which is a must; we have to document our interventions; and 3) you'll never do this again and it will probably make you a better nurse.

[cleback]

At my most recent hospital, everyone got their nebs with oxygen.

Are you alluding to the persistent misconception that oxygen will suppress the respiratory drive for co2 retainers? That's an old theory that has since fallen out of favor.

While there is such a thing as oxygen toxicity, 5L isn't that much. Just try not to make a habit of it.