Ateneo de Zamboanga University College of Nursing

NUSING SKILLS OUTPUT (NSO) Report No. _3_ OXYGEN DELIVERY I. DESCRIPTION: Oxygen is an odorless, tasteless, colorless, transparent gas that is slightly heavier than air. It is used to treat or prevent symptoms and manifestations of hypoxia. Oxygen can be dispensed from a cylinder, piped-in system, liquid oxygen reservoir, or oxygen concentrator. It may be administered by nasal cannula, transtracheal catheter, nasal cannula with reservoir, or various types of face masks, including CPAP mask. It may also be applied directly to the ET or tracheal tube by way of a mechanical ventilator, T-piece, or manual resuscitation bag. The method of selected depends on the required concentration of oxygen, desire variability in delivered oxygen concentration (none, minimal. moderate), and required ventilator assistance (mechanical ventilator, spontaneous breathing). II. MATERIALS/ EQUIPMENT NEEDED: Oxygen source Humidifier filled with sterile water Plastic cannula with connecting tubing (disposable) Flowmeter NO SMOKING signs

III. PROCEDURE 1. Explain procedure to patient and review safety precautions necessary when oxygen is in use. Place No Smoking sign in appropriate areas. 2. Perform hand hygiene. 3. Connect nasal cannula to oxygen setup with humidification, if one is in use. Adjust flow rate as ordered by physician. Check the oxygen is flowing out of prongs. 4. Place the prongs in patients nostrils. Adjust according to type of equipment: a. b. Over and behind each ear with adjuster comfortably under chin or Around patients head.

5. Use gauze pads at ear beneath tubing as necessary. 6. Encourage patient to breathe through nose with mouth closed. 7. Perform hand hygiene. 8. Assess and chart patients response to therapy.

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9. Remove and clean cannula and assess nares at least every 8 hours or according to agency recommendations. Check nares for evidence of irrigation or bleeding.

IV. DIAGRAM/ ILLUSTRATIONS:

V. NURSING RESPONSIBILITIES: 1. BEFORE PROCEDURE Verify correct patient. Determine current vital signs, LOC, and most recent ABG. Assess risk of CO2 retention with oxygen administration.

2. DURING PROCEDURE Post NO SMOKING signs on the patients door and in view of the patient and visitors. Show the nasal cannula to the patient and explain the procedure. Make sure humidifier is filled to the appropriate mark. Attach the connecting tube from the nasal cannula to the humidifier outlet. Set the flow rate at the prescribed liters per minute. Feel to determine if oxygen is flowing through the tips of the cannula. Place the tips of the cannula in the patients nose and adjust straps around around ears and snug, comfortable fit. 3. AFTER PROCEDURE Record flow rate used and immediate patient response. Assess the patients condition, ABG or SaO2 and the functioning of equipment at regular intervals. Determine patient comfort with oxygen use.

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Reference: http://nursingcrib.com/demo-checklist/administering-oxygen-by-nasal-cannula/ Lippincotts Textbook of Manual Nursing Practice 9th Edition by Williams and Wilkins, Volume 1, pp. 484-485

JULY 4, 5, 6, 2013 Date

MS. MARIA ELEANOR B. MANUEL Clinical Instructors Initials EIREES JOY A. MENDOZA BSN III-D

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