Oxygen Therapy

The provision of therapeutic

oxygen is required whenever
hypoxemia occurs, i. e.
reduced O2 in the blood
stream.
Sources of oxygen:
1. Wall outlet
2. Portable cylinders or
tanks
Parts of the Oxygen Tank:
Regulator – use to release O2
safely with a desirable rate.
– controls rate of
oxygen output
Flow rate meter – indicates # of
liters per minute of O2 being
released
Pressure Gauge – the one
nearest to the tank which shows
the pressure or amount of
oxygen in the tank.
Precautions when administering
Oxygen:
• Avoid open flames in patients
room such as burning candles
& striking match.
• Place “NO SMOKING” signs in
conspicuous places in the
patient’s room.
3. Check all electrical
equipments. Ensure that it
emits no sparks.
4. Avoid wearing & using
synthetic fabrics.
5. Avoid using oil, or wearing
clothing stained with oil in the
area.
Clinical Alert: Oxygen is used very
conservatively on anyone with
chronic lung disease because high
levels of oxygen will disrupt
carbon dioxide center & lead to
respiratory arrest.
• Administration of Oxygen
Therapy by Nasal Cannula.
Description: This equipments
the simplest method & the one
best set tolerated by most
patients.
Cannula-is a disposable plastic
device with two protruding
prongs for insertion into the
nostrils
Equipments: Oxygen supply
Regulator
Humidifier
Nasal Cannula
PROCEDURE:
2.Explain purpose & procedures
of oxygen to patient
R- To alleviate anxiety & gain
patient’s cooperation
2. Take actions to minimize fire
hazards.
3. Attach humidifier bottle to
regulator & attach nasal cannula
to connecting tube of water
reservoir.
R- Prevents dryness & irritation
of nasal mucosa
4. Lubricate cannula prongs with
water soluble lubricant & start
flow of Oxygen at 2-4 LPM
R- Oil soluble lubricants emit
heat.
5. Place prongs in patient’s
nostrils. Prongs should curve
outward in nostrils. Position
tubing over & behind each ear &
slide the adjuster under skin so
that the cannula fits snugly but
comfortably.
R- Correct placement of prongs
& fastener facilitates oxygen
administration & comfort for the
patient.
6. Use gauze pads as necessary
under nostril, cheeks or behind
the ears,
R- To reduce irritation &
pressure.
7. Instruct patient to breath
through nose.
R- For maximum efficiency of
cannula.
8. Monitor vital signs & check
patient’s condition frequently.
R- To note any signs of distress.
9. Provide nose care at least every
four (4) hours.
R- To promote comfort & prevent
dryness of nasal mucosa.
10. Change equipment daily
(tubing and cannula)
11.Administration of oxygen via
Nasal Catheter:
Description: Nasal or
oropharyngeal catheter is a very
efficient means of administering
oxygen because it delivers a
higher concentration of oxygen.
Equipments: Nasal Catheter-
sizes: No. 8-10 F for children
No 10-12 F for women
No 12-14 F for men
Water soluble lubricating jelly,
adhesive tape, humidifier,
flashlight & tongue depressor,
oxygen supply, regulator.
PROCEDURES:
2.Explain procedure to patient.
R- To alleviate anxiety & gain
patient’s cooperation.
2. Attach catheter to connecting
tubing. Attach humidifier to flow
meter, then to wall of oxygen
tank after cracking tank.
R- To prevent dryness of the
nasal mucosa.
3. Measure catheter by holding it
in a horizontal line from tip of
nose to the earlobe. Mark it with
narrow strip of the tape.
R- approximates the lengths of
catheter that is needed to be
inserted.
4. Lubricate tip of catheter with
water-lubricant.
R- To facilitate catheter
insertion.
5. Turn oxygen to 3 LMP & test
oxygen flow by placing over
your hand to feel for flow.
R- assuring that oxygen will be
delivered at concentration needed
6. Position patient with neck
hyper extended.
R- To facilitate catheter
insertion.
7. Ensure flow of oxygen.
8. Slowly insert catheter no
more than 5 cm into nares.
R- Make sure that injury will not
be done to the nasal mucosa.
9. Examine placement by
depressing the patient’s tongue
depressor & observe throat.
R- To make sure that oxygen is
being delivered at concentration
needed.
10. Adjust flow rate to liters
ordered (Limited to 5 LPM).
R- Nasal Catheters delivers a
higher concentration of oxygen
11. Secure catheter to bridge of
the patient’s nose with tape.
R- To prevent catheter to be
dislodged.
12. Instruct patient to breath
through his nose.
13. Palpate the epigastrium.
R- To asses for gastric
distention
14. Remain with patient
R- To provide psychological
support
15. Provide mouth & nostril care
every 2-3 hours.
R- To promote comfort.
16. Remove & change catheter
in the opposite nare every 8
hours.
III. Administration of Oxygen by
Face Mask
Description: The use of
disposable & reusable face mask
for oxygen.
Points to Remember:
1. Mask should be fitted carefully
to the patient’s face to avoid
leakage of oxygen
2. Mask should be comfortable,
snug but not too tight against
the patient’s face.
Types of Face Mask:
• Disposable Plastic Mask-
simplest, less expensive; with
open vents for elimination of
exhaled air.
2. Concentration Mask- Designed
to supply specific concentration
of oxygen up to about 40%. This
mask permits the more precise
administration of oxygen at low
concentration.
3. Partial Rebreathing Mask- No
respiratory valve so that the
beginning portion of exhaled air
returns to the bag & mixes with
the inspired air. Ports are
present so that expired air
escapes.
4. Nonbreathing Mask- Provides
highest concentration for the
patient & offers the most precise
method of administration. With
valve which closes during
expiration so that any exhaled
air is forced thru the expiratory
valve on the face piece.
5. Venturi Mask- Use to control
low oxygen concentration; Allows
a fixed predicted FIO to be
2

delivered. It is utilized effectively

on patients with COPD when
accurate FIO is necessary for
2

proper treatment. CO2 build up is

kept at minimum.
EQUIPMENTS: Oxygen mask, Oxygen
source, Flow-meter, Humidifier
PROCEDURES:
2.Explain procedure & rationale
for administering oxygen to
patient.
R- To relieve anxiety & gain
patient’s cooperation.
2. Observe precautions to
prevent fire
R- Oxygen supports combustion
3. If used, attach a water
humidifier bottle to the oxygen
regulator or flow meter.
R- Humidifiers prevent mucosal
dryness.
4. Measure size of face mask for
patient’s use
R- To make sure it fits the patient.
5. Turn on oxygen flow to LPM
(prescribed). If reservoir bag is
attached, partially inflate it with
oxygen.
R- So that the patient will not
feel suffocated as the mask is fit.
6. Place patient in semi or higher
fowler’s position
R- To promote maximum vital
capacity
7. Fit mask to patient’s face
from nose downward during
expiration. If reservoir bag is
attached, oxygen flow must be
at level.
R- A tight fit prevents oxygen from
escaping around eyes or nose.
8. Place elastic band around
patient’s head
R- To avoid mask displacement.
9. Attach tubing to pillows & bed
keeping tubing free of kinks.
R- To facilitate a good oxygen
flow
10. Use gauze pads on patient’s
ear & scalp.
11. Instruct patient to breath
thru nose if nasal mask has
been used.
12. Stay with the patient until
patient feels at ease with the
mask.
R- Some patient may be afraid of
the mask
13. Asses patient’s condition
frequently
R- To monitor any signs of
distress
14. Remove & clean face mask
every 2-3 hrs. if oxygen is
running continuously.
R- Promotes comfort.
15. Check the equipment &
water level of humidifier
frequently.
16. Observe for any change in
patient’s condition.
17. Check with physician to
order a nasal cannula during
meals.
IV. Administering Oxygen by
Tent.
Oxygen tent:
-A light portable structure made
of clear plastics & attached to a
motor driven unit.
-A useful for high concentrations
of oxygen (50-60%) & for
circulation of moist air around the
patient.
-It will provide low moderate
concentration of oxygen in a
temp. controlled environment.
Equipments: Oxygen tent, Oxygen
machine, Oxygen analyzer, non-
electrical call bell, draw sheets
PROCEDURES:
3.Secure tent & place machine at
head of bed with control knobs on
opposite side where working area is
required.
R- Provide enough space for delivery
of care
2. Connect regulator to oxygen
source. Plug machine.
3. Set up humidifier & check to
make sure that water level (tray
at back of machine) is adequate.
R- To ensure circulation of moist
air around the patient.
4.Turn on oxygen flow & flush
with high liter rate, or press
flush button for one minute until
desired concentration is reached.
5. Position canopy ½ to 1/3 over
length of bed.
6. Flush oxygen with 15 LPM flow
rate for 1-2 minutes.
R- To prevent feeling suffocated as
client is placed inside the tent.
7. Tuck all sides of canopy into mattress
R- To avoid oxygen to leak.
8. Regulate flow meter to 12-15
LPM (minimum of 10 LPM)
R- To provide a moderate
concentration of oxygen to the
patient.
9. Give patient a special call
button that can be attached to
bed.
R- To facilitate communication
of needs.
10. During use open tent if
necessary.
R- To maintain tent efficiency.
11. If patient complains of coldness,
furnish, additional clothing, wrap
patient’s head & shoulders, or
adjust the temp. of the bed.
12. Check equipment every 4
hours. Oxygen vent should
remain unobstructed.
R- Equipments must function
adequately.
13. Observe patient’s progress &
report to physician any untoward
signs & symptoms.