Determines the need for oxygen therapy and Verifies the order for the therapy by checking:

R: Reduc the risk of error in administration

 the order for oxygen, including the administering device and the liter flow rate (L/min) or the percentage of oxygen;
 the levels of oxygen (PaO2) and carbon dioxide (PaCO2) in the client’s arterial blood (PaO2 is normally 80 to Administering Oxygen by
Cannula
 whether the client has COPD. Note: If the client has not had arterial blood gases ordered, oxygen saturation should be checked using a non-
invasive oximeter. (pulse oximeter)
R: because clients with COPD requires low dose of oxygen to the patient and too much oxygen could lead to hypoxemia
Performs a respiratory assessment to develop baseline data if not already available.
R: provide baseline data fo future assessment
USE:PULSE OXIMETER

P: Good Day Sir! I am Beatrice Chi, a SN., from Davao Doctors College & Today. I am here because I am going to assessed your Respiratory
System prior to administering Oxygen. Is that okay with you sir?

 SKIN MUCOUS MEMBRANE: CYANOSIS/MUCUS/SPUTUM PROD/

 BREATHING PATTERNS: BRADYPNEA/TACHYPNEA/ORTHOPNEA
 CHEST MOVEMENTS: INTERCOSTAL/SUBSTERNAL/SUPRACLAVICULAR/ OR TRACHEAL RETRACTIONS DURIN INSPI & EXPI
 CHEST WALL CONFIGURATION: KYPHOSIS/UNEQUAL EXPANSION/ BARREL CHEST
 LUNG SOUNDS: WHEEZE/STRIDOR/STERTOR/BUBBLING
 PRESENCE OF HYPOXEMIA: TACHYCARDIA/TACHYPNEA
 PRESENCE OF HYPERCARBIA: RESTLESSNESS/ HIGH BP

ASK:

Prepares the client and support people:

R: Severely compromised respiratory functioning causes fear and anxiety in patients and their families. Reassurance from the nurse can be helpf
P: Upon assessing your respiratory system, mababa po ang inyog O2 Saturation (80%) there is wheezing. Also upon my observation it looks like
have difficultly in breathing. So sir before I will administer oxygen with the use of a nasal cannula device. I want to assure you that this is safe for y
and this will help to support your breathing and increased airflow to your lungs.

a. Assists the client to a semi-flower's position if possible.

R: this position allows increased lung expansion hence easier breathing

P: ASSIST THE PATIENT

b. Explains that oxygen is not dangerous when safety precautions are observed.

R: Providing information foster the clients cooperation relieves his/her anxiety

P: Also sir, Safe po ang oxygen as long as ifollow lang po natin ang safety precautions. Make sure na hindi po galawin ang oxygen tank and yung
regulator kasi po this might harm you and also nurses lang po ang allowed mag regulate ng oxygen sir :)
c. Informs the client and support people about the safety precautions connected with oxygen use.
R: To provide safety to the client and reduce risk of danger
P: As, you can see meron po tayong no smoking sign sir and gusto ko rin po kayo iwarn na gina prohibited po ang mag smoke dito most espec
na may oxygen po tayo sa room ninyo and oxygen is highly combustible which means it is capabable na maka attract ng fire.
Prior to performing the procedure, introduces self and verifies the client's identity using agency
protocol.
R: To enhance rapport with client.
P:
a. Explains to the client what your are going to do, why is it necessary, and how he or she can
participate.
R: providing information foster the clients cooperation relieves his/her anxiety
P:
b. Discusses how the effects of the oxygen therapy will be used in planning further care or
treatments.
R:
P:
Performs hand hygiene and observes other appropriate infection prevention procedures.
R: To prevent spread possible infections.
Provides client privacy, appropriately.
R: To give repect and dignity to the client
Setting up the oxygen equipment and the humidifier:
R: Organization facilitate accurate skill performance
a. Attaches the flow meter to the wall outlet or tank. The flow meter should be in the off position.
R: Oxygen in high concentrations can be drying to the mucosa.
b. If needed, fills the humidifier bottle. (done before coming to the bedside)
R: humidification prevents drying of the nasal mucosa
c. Attaches the humidifier bottle to the base of the flow meter.
d. Attaches the prescribed oxygen tubing and delivery device to the humidifier.

Turns on the oxygen at the prescribed rate and ensures proper functioning.
a. Checks that the oxygen is flowing freely through the tubing.
R: Testing the flow before use is needed to provide prescribed oxygen to the client.
P:
b. Sets the oxygen at the flow rate odered.
R: The flowrate via the cannula should not exceed 6L/min higher because this may cause drying of nasal mucosa
Application of the appropriate oxygen delivery device:
a. Puts the cannula over the client's face, with the outlet prongs fitting into the nares and the
tubing hooked around the ears.
R: Proper position allows unobstructed oxygen flow and eases the client’s respiration.
c. If the cannula will not stay in place, tapes it at the sides of the face.
R: To prevent from getting out of place accidentally
d. Pads the tubing and band over the ears and cheekbones as needed.
R: constant tubing may cause skin breakdown
Assessment of the client:
a. Assesses the client's vital signs, level of anxiety, color, and ease of respirations, and provides
support while the client adjusts to the devices.
R: For baseline data, to identify the level of comfort of the patient and anxiety leads to increase demand for oxygen
b. Assesses the client in 15 to 30 minutes, depending on the client's condition.
c. Assesses the client regularly for clinical signs of hypoxia, tachycardia, confusion, dyspnea,
restlessness, and cyanosis.
R:
e. Reviews oxygen saturation or arterial blood gas results if available.
R:
Assessment for Nasal Cannula:
a. Assesses the client's nares for encrustations and irritation.
R: Nares can become dry, irritated in long use cases

b. Applies a water-soluble lubricant as required to soothe the mucous membranes.

c. Assesses the top of the client's ears for any signs of irritation from the cannula tubing. If present,
padding with a gauze pad may help relieve the discomfort.
R:In long use cases, evaluate for pressures sores.

Inspects the equipment on a regular basis.

R: Help identifying any complications that may arise.

a. Checks the liter flow and the level of water in the humidifier in 30 minutes and whenever
providing care to the client.
R: Sterile water should be added when the level falls below the line on the humidification container.

b. Makes sure the safety precautions are being followed.

Performs hand washing/hand hygiene and aftercare.
R:Reduce risk transmission of microorganisms

Documents findings in the client record using forms or checklists supplemented by narrative notes
when appropriate. (Date, Time, Method, Flow Rate, Respiratory condition, Response to Oxygen)
R:Documentation provide coordination of care

Oxygen Administration
 is the process by which of supplemented oxygen is administered in high concentration than that of atmospheric air.
Nasal Cannula or Nasal Prongs
 most common and inexpensive device used to administer oxygen.
 it is easy to apply and do not interfere with clients ability to eat or talk
 It is relatively comfortable, allows freedom of movement and is well tolerated by the client.
 It delivers a low concentration of oxygen for about: 24% to 45% at FR: 2 to 6 L/min

So, to start I will first do the PREPARATION: