护理学基础双语教学-授课教案:11 Oxygen therapy

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护理学基础双语教学授课教案:11 Oxygen therapy:南方医科大学教案2006—2007学年Autumn学期所在单位NursingSchool系、教研室Departmentoffundamentnursing课程名称fundamentnursing授课对象Undergraduatestudentforbachelordegreeinnursing2004grade授课教师ShiLei（史蕾)职称Teac

南方医科大学

教案

2006 — 2007 学年 Autumn 学期

所在单位 NursingSchool

系、教研室 Department of fundamentnursing

课程名称 fundamentnursing

授课对象 Undergraduate student forbachelor

degree in nursing 2004grade

授课教师 Shi Lei （史蕾)

职称 Teachingassistant

教材名称 Basic nursing skills（bilingualism)

授课题目 OxygenTherapy

南方医科大学教案首页

授课题目	Oxygen Therapy	授课形式	lecture and demonstrate
授课时间	2006．12．20	授课学时	2
教学目的与要求	1. State indications of oxygen therapy 2. Expatiate on precautions of oxygen therapy 3. State different sources of oxygen and methods of oxygen delivery 4. Demonstrate the procedure of administering oxygen therapy by nasal tube correctly 5. State complications of oxygen therapy and expatiate how to prevent
基本内容	1. Classification of Hypoxia 2. Level of Hypoxia 3. Indication of Oxygen Therapy 4. Sources of Oxygen 5. Methods of Oxygen Delivery 6. Implement of Oxygen Therapy 7. Complications of Oxygen Therapy
重点难点	1. Implement of Oxygen Therapy 2. Precautions of oxygen therapy
主要教学媒体	PPT
主要外语词汇	Oxygen Therapy 、Hypoxia 、Hypotonic、Hemic 、Histogenous 、Hemoglobin、Anemia、Cyanide poisoning
有关本内容的新进展
主要参考资料或相关网站	1、Zhou Kexiong. Basic Nursing Skills 2、SABDRA F.SMITH. Clinical Nursing Skills. Prentice Hall Health.
系、教研室 www.lindalemus.com/wszg/ 审查意见	已审合格，同意授课。
课后体会	1. 课程设置合理，无超时。 2. 本节内容理论性强，操作相对简单，使用双语教学，效果较好。 3. 对难点、重点用英文称述加中文解释，学生基本能听懂。

教学过程

教学内容

时间分配和

媒体选择

Oxygen Therapy

Oxygen is necessary for all living cells. The absence of oxygen can cause death. The circulatory and respiratory systems work together to meet our body’s demands of oxygen. Impaired of either system may significantly affect the function of oxygenation.

Purpose of oxygen therapy:

• To raise PaO2，SaO2，and CaO2

• To prevent or relieve hypoxia

• To promote metabolism

Function of Respiration:

Classification of Hypoxia：

Classification	Characteristics	Causes
Hypotonic ~	PaO₂ CaO₂	High altitude disease, COPD, Heart disease
Circulatory ~	Poor tissue perfusion with oxygenated blood	Shock, Heart failure
Hemic ~	Inadequate or alterations of quality of hemoglobin	Anemia, CO poisoning
Histogenous ~	Inability of tissues to extract oxygen from blood	Cyanide poisoning

Indication of Oxygen Therapy：

Hypotonic hypoxia: the best

Oxygen therapy may have effect on clients with heart failure, shock, severe anemia, or carbon monoxide poisoning.

Level of Hypoxia：

Level	Cyanosis	Dyspnea	Consciousness	PaO2 (mmHg)	SaO2 (﹪)
Light ~	no	no slight	clarity	＞50	＞80
Mild ~	have	have	normal or fidget	30-50	60-80
Severe ~	severe	severe	coma	＜30	＜60

Index of Oxygen Therapy：

v Light hypoxia: not indicated for client

v Mild hypoxia: need oxygen therapy

v Severe hypoxia: absolute indication

Sources of Oxygen：

1) Oxygen Cylinder System

2) wall Outlet Supply

3) Oxygen Bag

4) High Pressure Cabin

Methods of Oxygen Delivery：

1) Nasal Catheter

2) Nasal Cannula

3) Oxygen Mask

4) Oxygen Hood

5) Oxygen Tent

Administering Oxygen by Nasal Catheter

【Purpose】

To prevent or relieve hypoxia

To raise PaO₂, SaO₂, and CaO₂ and attain good effect for clients with hypoxia

【Equipment】

Equipment for oxygen supply source (Figure 12-1):

Oxygen cylinder

Cylinder cart

Regulator

Humidifier

Distilled water

Equipment for using a nasal catheter:

Therapeutic tray:

l Nasal catheter

l Kidney basin

l Hemostatic forceps

l Therapeutic bowl with distilled water

l Swab stick

l Adhesive tape

l Record card

l A small pin, etc.

Equipment for removing a nasal catheter:

Kidney basin

Gauze

【Procedure】

Installing an oxygen regulator:

1. Place oxygen cylinder in secure, upright position. Rationale: Oxygen in high concentration and high pressure has great combustion potential.

2. Check tag to determine amount of oxygen in the cylinder. Rationale: This will facilitate your work to change cylinder in time and save time at first aid.

3. Slowly turn on general switch clockwise to crack open for a brief second to clear opening of cylinder, then close. Rationale: This can blow away dust in the orifice of cylinder outlet.

4. Attach regulator to the outlet. Place regulator in upright position. Rationale: To regulate gas flow in liters per minute.

5. Fill humidifier with distilled water to indicated level on bottle. The lever is 1/3-1/2 volume of bottle. Rationale: Humidity prevents nasal mucosa from drying out. 20%-30% alcohol solution is used to humidify oxygen for client with acute pulmonary edema.

6. Attach one side of rubber tube and humidifying bottle to oxygen regulator.

7. Switch on cylinder to open flow, then slowly open switch of regulator and check if there is obstruction or gas leak in the tubing.

8. Turn off the switch of regulator and prepare for use.

General switch

Humidifying bottle

Flowmeter

Pressure gauge

Safe

valve

Cylinder

Figure 12-1 oxygen cylinder and regulator

Inserting a nasal catheter

9. Check physician’s orders for oxygen prescription including method of delivery and flow rate. Rationale: Oxygen as medicine must be ordered by a physician. Oxygen delivered by nasal tube is prescribed in flow rate expressed as liters per minute(L/min).

10. Wash your hands, wear a mask.

11. Gather equipment into a smell therapeutic tray. Place the tray on a medication trolly, then bring it to room.

12. Identify correct client, explain the purpose and procedure of oxygen use briefly to client.

13. Check oxygen supply devices once again.

14. Examine nostrils, and select the most patent nostril by having client breathe through each one. Rationale: The nostril with greater airflow should be chosen for insertion. Clean nasal cavity with wet swab stick.

15. Connect one side of nasal catheter to free end of rubber tubing.

16. Switch on oxygen regulator, put the free end of the nasal catheter in bowl to lubricate it. This also is done to observe if bubbling occurred indicating that the tube is patency.

17. Turn off oxygen regulator, disconnect nasal catheter from rubber tubing.

18. Measure length for insertion (Figure 12-2). Rational: Measure from tip of nose to earlobe, two thirds of the length is appropriate for tube insertion.

Figure 12-2 Measure length for insertion

19. Insert tube gently through nostril to nasopharynx.

20. Tape tube securely to nose and cheek.

21. Turn on oxygen flow to liters prescribed.(light hypoxia:1-2L/min;mild hypoxia:2-4L/min; severe hypoxia:4-6L/min;child:1-2L/min) Rational: Oxygen therapy and liters of oxygen flow per minute is administered according to assessment of the clients' state of hypoxemia.

22. Connect nasal tube to rubber tubing.

23. Secure tube with pin to client’s gown or bed linen, leaving some degree of slack for head movement.

24. Write down time and flow of oxygen supply on the record card. Rationale: Record information for evaluation and promote continuity of care.

25. Assist client to a comfortable position.

26. Assess the client regularly. Rationale: Evaluate effects and side effects of oxygen therapy.

27. Check the equipment regula医学全.在线www.lindalemus.comrly，including the liter flow and the level of water in the humidifier. Make sure that safety precaution is being followed. Rationale: Ensure safety of oxygen therapy.

Removing a nasal catheter

28. Disconnect nasal tube from rubber tubing .

29. Switch off oxygen cylinder. Loosen tape on nose and cheek.

30. Take a piece of gauze in each hand and remove nasal tube with continuous steady pull.

31. Clean client’s face, especially nares. Unpin tube from gown.

32. Switch off regulator and record the finish time of the procedure.

33. Dispose of equipment appropriately. Rationale: Prevent cross-contamination.

Precaution for oxygen therapy

• Disconnect nasal tube from rubber tubing before adjusting flow meter

• Change nasal tube two times a day , use nares by turns

• Clean nasal cavity in time

• Check equipment frequently, if humidifier is attached ,check water lever in time