# Titrate Oxygen – COPD Nursing Care in ER

by Rhonda Lawes, PhD, RN

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Slides Nursing Care COPD Patient.pdf
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Reference List Medical Surgical Nursing and Pathophysiology Nursing.pdf
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00:00 Now I wanna go back to that word 'titrate'.

00:03 What does it mean to titrate oxygen? We see on the screen, we have an oxygen flow meter.

00:11 See that little green knob on it? That's what we turn up and down and that little ball will float.

00:17 Wherever the middle of that ball is, that's gonna tell us how many liters of oxygen the patient is receiving.

00:23 So you're gonna titrate it by turning that knob so that you can make sure you changed the amount or the liters that the patient is receiving.

00:32 We'll look at our orders.

00:35 Every 15 minutes, we're gonna go up a little bit on that if we can't keep a sat at 93.

00:41 Now we're gonna go all the way up to 4 liters and if that still can't maintain the sat, then we're gonna switch to a Venturi mask.

00:49 So those are the orders the health care provider has written for us for titrating the oxygen.

00:54 You're gonna monitor the pulse ox, make small changes in the oxygen as ordered until the target pulse ox reading is reached.

01:02 So that's what it means when you get a titrating an oxygen order.

01:07 Think of it as kinda like a sliding scale that we use with insulin.

01:09 If you have this number as a blood sugar, the physician has written orders for how much insulin you give.

01:15 Same thing with titrating oxygen.

01:18 If you have this pulse ox, these are the changes -- the small changes you make in the O2 amount of liters the patient gets per minute.

01:26 Okay, so let's practice.

01:27 Got the order, titrate oxygen on nasal cannula 1 liter every 15 minutes.

01:34 So I know I'm only gonna go up what amount? Right, 1 liter and I'm gonna check every 15 minutes trying to get that pulse ox between 90 and 93.

01:44 Now if you can't keep the pulse ox after 15 minutes and we've gone up to 4 liters, then we're gonna change to a Venturi mask.

01:52 So let's take another patient. I'm just gonna give you a patient that's not Mrs. Taylor, okay? So the example, it's 8 o'clock in the morning. The patient's pulse ox is 88%.

02:02 We have this order for the patient. They're on 2 liters of oxygen per nasal cannula.

02:06 What do you do? Okay, well, 88% is not in the range of 90-93 so I need to do something.

02:16 I need to change it. The order tells me to increase by how much? Right, 1 liter. So what I should do is increase the oxygen from 2 liters to 3 liters by changing that knob on the oxygen flow meter.

02:32 When should I recheck the pulse ox? The order tells me in 15 minutes.

02:37 So you wanna give it some time for the oxygen to settle in and see if it's gonna be enough for it.

02:42 So we wait every 15 minutes, we'll keep going up on the oxygen.

02:46 Now if the patient's status drastically changes, we would do something different.

02:51 We're talking about the patient stays relatively the same or better, we're gonna do this slowly 1 liter of oxygen at a time.

02:59 So that's an example of another patient, not Mrs. Taylor.

03:03 Now we're gonna apply this order to what we would actually do for Mrs. Taylor.

The lecture Titrate Oxygen – COPD Nursing Care in ER by Rhonda Lawes, PhD, RN is from the course Respiratory Case Study: Nursing Care of COPD Patient.

### Included Quiz Questions

1. Oxygen titration
2. Oxygen dumping
3. High flow oxygen monitoring
4. Oxygen toxicity
1. one liter every 15 minutes
2. one liter every minute
3. three liters every 15 minutes
4. three liters every minute

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