Oxygen therapy refers to administration of oxygen to a patient as a medical intervention. The purposes can vary in care for both chronic and acute patients. It is normally used when a patient is hypoxic and is unable to supply his or her cells with enough oxygen through normal respiratory processes. The delivery system chosen depends on the age of the patient, humidification needs, oxygen requirements or the therapeutic goals, and, the patient’s tolerance to the selected interface.
(Roca, Riera, Torres, & Masclans, 2010). (Pauwels, Buist, Calverley, Jenkins, & Hurd, 2012).
The nursing actions needed to assist Mr. Jerrison’s respiratory status are first measurement of the arterial oxygen concentration. This will help the nurse to estimate the level of hypoxemia. If the blood PaO2 is very low, it may be necessary for the nurse to put him on oxygen therapy to help improve the level of PaO2. The oxygen can be delivered in a face mask with no need to mechanically ventilate.
Sleep apnea is a respiratory disorder that presents as pauses in breathing during sleeping. It is normally diagnosed in patients through a sleep study. The main causative agents are familial inheritance of a narrow throat, obesity, smoking, and use of alcohol, sedatives and opioids which normally relax the airway muscles making them flaccid thus obstruction of the airway. Such patients can be treated using the CPAP devices which maintain the airway pressure at a higher level to prevent its collapse and closure. It refers to continuous positive airway pressure. The patient gets a demonstration by the provider on how he or she should fit the face mask to prevent it from applying too much pressure on the face and at the same time keep it on the face overnight. In addition, he or she is shown how he can make adjustments to the device to get the therapeutically desired effects. The level of pressure provided by the device is determined by the provider during the sleep test. Some of the interventions that are meant to improve the compliance include; changing the system to a level one if the patient is unable to adapt to the CPAP. The second intervention is changing their mask if the patient’s current must is not properly fitting. Lastly, changing masks if the patient has an allergic reaction to the one he is currently using.
Asthma is caused by environmental factors and genetic factors. The environmental factors are referred to as allergens and include animal fur, dust, cold and pollen. It normally presents with wheezing, difficulty in breathing, cough that is productive and chest pain mostly occurring after contact with the allergen. Asthma caused by environmental factors is more common than asthma caused by genetic factors. Therefore, in most cases, it is preventable. It can be treated with bronchodilators like salbutamol and also steroids to prevent inflammation. Chronic bronchitis is caused by is caused by inflammation of bronchial tubes. It causes a productive cough, chest tightness and wheezing. The most common cause is cigarette smoking. However, passive smokers also risk contracting chronic bronchitis. It can also result from breathing in poisonous gases. As such, workers working in industrial zone are prone to chronic bronchitis. It is normally treated with steroid to control the inflammation and also propranolol to reduce the amount of secretions in the airways. Emphysema involves damage of air sacs in the lungs. It leads to a chronic cough and difficulty in breathing during exercise. It is normally caused by cigarette smoking. However, passive smokers also risk contracting it as well. It is treated with oxygen therapy, inhaler and sometimes surgery. Pneumonia can be caused by infectious organisms like bacteria and viruses, and sometimes through autoimmune reactions to some drugs. The symptoms of Pneumonia include fever, chest pain, a cough and difficulty breathing. Treatment depends on the underlying cause. It is bacterially caused; antibiotics are used to cure it. If it virally caused, antiviral drugs are used to treat it. In the case of autoimmune reactions to drugs, the drug is withdrawn, and the condition gets better.
The priority problem for Mr. Etterly is chronic obstructive pulmonary disease. The nurse could identify the problem based on the physical examination findings which include increased AP chest diameter giving him a barrel chest, finger clubbing and the use of accessory muscles of respiration. These findings are further supported by the laboratory findings of reduced PaO2. This implies compromised oxygen supply, increased PaCO2 meaning impaired CO2 excretion and thus leading to the reduced blood PH due to the increased acidity. The physical symptoms like a frequent productive cough, chest pain and shortness of breath are as a result of the resultant hypoxia. The desirable outcome for this patient is improved oxygen supply and alleviation of the symptoms of pain, productive cough and shortness of breath. The nurse should anticipate the provider to order bronchodilators like salbutamol to help relax the airway muscle of Mr. Etterly and improve air circulation. He will also order him to be put on oxygen therapy if he is in a very critical condition.
References
Pauwels, R. A., Buist, A. S., Calverley, P. M., Jenkins, C. R., & Hurd, S. S. (2012). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine 163(5).
Roca, O., Riera, J., Torres, F., & Masclans, J. R. (2010). High-flow oxygen therapy in acute respiratory failure. Respiratory Care, 55(4), , 408-413.
