PROCEDURE ON

OXYGEN THERAPY

SUBMITTED TO SUBMITTED BY

Mrs.Priyadarshini Madam Pasunoori. Lavanya

Faculty M.Sc (N) I Year

Govt. College of Nursing Govt. College of Nursing

Hyderabad Hyderabad
 STUDENT PROFILE

Name of the student : Pasunoori Lavanya

Course : M.Sc (Nursing)

Class : 1st year

Subject : Nursing Foundation

Unit :

Topic : Oxygen Therapy

Method of Teaching : Lecture cum Discussion

Group : B.Sc (Nursing) 1st year

Place & Date : B.Sc nursing 1st year classroom on 30/12/2023

Duration : 1 hour

A.V aids : OHP, Blackboard, Flashcards, PPT, Charts.

 OBJECTIVES

General Objectives:

By the end of the class all the students will be able to gain in-depth knowledge and skills regarding oxygen therapy.

Specific Objectives:

By the end of the discussion the group will be able to

• Definition of oxygen therapy

• Purposes of oxygen therapy
• Indications and contraindication of oxygen therapy
• Sources of oxygen
• Oxygen delivery systems
• Methods of oxygen administration
• General instructions to be kept in mind while doing the procedure
• Preparation of the patient for the procedure
• After care of the patient and articles
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To explain about the Introduction.
introduction of Air, water and food are the three essentials of Lecture method
oxygen therapy 2min life. The air that we. Breathe contains What is
approximately 21% of oxygen. Every single air or oxygen
tissues need oxygen to survive or to perform therapy?
metabolism. Oxygen is a colorless, odorless,
tasteless gas that is essential for the body to
function properly and to survive. Oxygen is given
when there is a interference with the normal
oxygen of body tissues.
2min

Definition of oxygen Therapy: Definition of

Define the oxygen Lecture method OHP
therapy Oxygen therapy is a treatment that delivers oxygen
therapy?
oxygen gas to breathe. The oxygen therapy is
received from the tubes resting in nose or face
mask or a tube placed in a trachea or windpipe.
This treatment increases the amount of oxygen in
lungs to receive and deliver to blood.
 Objective Time Content Teaching/Lear A.V Evaluation
ning activity aids
Explain the Purposes of oxygen therapy:
purposes of ▪ To facilitate normal metabolism to tissues.
oxygen 2min ▪ To reduce or correct arterial hypoxemia.
therapy ▪ To increase oxygen. Saturation in tissues where
the saturation in the tissues levels are too low due Lecture cum OHP List the
discussion purposes of
to illness or injury. oxygen
Indications of oxygen therapy: therapy?
List the 1min
✓ Acute respiratory failure.
indications of
✓ Restlessness or labored breathing.
oxygen
therapy ✓ Shock and circulatory failure.
✓ High altitudes.
✓ Patients with a decreased respiratory capacity.
✓ Patients under anesthesia.
✓ Patients who are critically in.
✓ During CPR.
✓ Anemia.
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✓ Cyanide poisoning.
✓ Hyper Metabolic state induced by trauma, burns or
sepsis.
✓ Myocardial infarction/Cardiac failure.
✓ Post anesthesia recovery.
Contraindications:
Explain the 2min ▪ Administer with caution to the patient with COPD.
contraindicati
Lecture cum Hand List the
ons of oxygen (Chronic Obstructive pulmonary disorder) as it
discussion outs contraindicati
therapy
induced hyperventilation. ons?
▪ Atelectasis
▪ Oxygen toxicity
▪ Poor efforts, Apnea.
▪ Severe hypoxia
▪ Mouth breathing.
Sources of oxygen therapy:
• Oxygen cylinder
 • Oxygen wall outlets.
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activity
Discuss the Oxygen cylinders:
sources of 3min The oxygen cylinder is delivered with a protective Explain
oxygen cap to prevent accidental force against the cylinder outlet. Lecture cum Ppt sources of
therapy discussion OT?
➢ To release oxygen safely and at a desirable rate, a
regulator is used.
➢ A reduction gauze that shows the amount of oxygen
in the tank.
➢ A flow meter that regulates the control of oxygen in
liters per minutes.
➢ Oxygen is moistened by passing it through a
humidifier to prevent the mucous membranes of the
respiratory track from getting dry
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Care of oxygen cylinder:
• Always the cylinder with Metal Gear to
prevent the danger of falling and breaking.
Explain care of • Oxygen cylinders should be placed at the
oxygen
3min Ppt
cylinders head of head end of the bed, Away from
Explain
the traffic areas where these are likely to
handling of
be knocked down. cylinders?
• Any source of The fire should be kept
away from the cylinder for fear of fire.
• Oxygen cylinder should be stored In a cool
temperature away from the heaters.
• Put the warning sign (No smoking) In the
unit where oxygen is on.
• Mark the empty cylinder and send for its
working condition.
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• Inspect the apparatus at frequent intervals
for its working condition.
Wall outlet oxygen:
✓ The oxygen is supplied from a central source
Discuss the through a pipeline.
sources of
2min ✓ Only a flow meter and a humidifier are Lecture cum Ppt
oxygen
discussion
required.
Wall outlet oxygen

Oxygen. Delivery System:

✓ Nasal cannula.
✓ Simple mask
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✓ Partial rebreather mask.
✓ Non rebreather mask. (NRBM)
✓ Venturi mask.
✓ Oxygen hood.
✓ Oxygen tent.
✓ Ambu bag
✓ Tracheostomy collor
Explain the 7min Lecture cum How to
✓ T – piece
oxygen discussion administer
administration Methods of oxygen administration: O2?
Nasal cannula (Prongs):
It is a disposable plastic device with two
protruding prongs. For insertion into the nostrils
corrected to an oxygen sources.
Used for low medium concentration of
oxygen (24 to 44%)
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Advantages of Nasal cannula:

➢ Client able to talk and eat with oxygen in
place
➢ Easily used in home setting. Safe and simple
➢ Easily tolerated.
➢ Deliver low concentration of oxygen.
Disadvantages:
➢ Unable to use with nasal obstruction.
➢ Drying to mucus membrane so flow greater
than 4 liters per minute needs to be
humidified
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➢ Can dislodge from Nares easily.
➢ Causes skin irritation or breakdown over
ears or at nares not good for mouth breather.
➢ Patients breathing Pattern affects exact
FiO2.
Face mask:
▪ The simple oxygen mask.
▪ The partial rebreather mask
▪ The nose rebreather mask
▪ The Venturi mask.
The simple oxygen mask:
• Simple mask. Is made of clear. Flexible.
Plastic or rubber that can be molded to fit the
face
• It is held to the head with elastic bands.
• Some have a metal clip that can be. Bent
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over the bridge of the nose. For a comfortable fit.

• It delivers 35% to 60% oxygen.

• A flow rate Of 6 to 10 liters per minute.
• It has events on its sides which allow room
air to leak at many places, thereby diluting
the sources of oxygen.
Advantages of simple oxygen mask:
Can provide increased delivery of oxygen for
short period of time.
Disadvantages:
Difficulty to keep mask in position over nose
and mouth.
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• Potential for skin breakdown (Pressure
moisture)
• Uncomfortable for patient while eating or
talking.
• Expensive with nasal tube.
The partial rebreather mask:
• The mask is with a reservoir bag that must
remain inflated during both inspiration and
expiration.
• It collects off part of the patients exhaled air.
• It is used to deliver oxygen concentration up
to 80%.
• Oxygen flow rate must be. Maintained at a
minimum of 6 liters per minute to ensure
that patient does not rebreathe Large amount
of exhaled AIR.
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• The remaining exhaled air exist through the
vents.

Advantages:
• Client can inhale room air through openings
in mask if oxygen supply is briefly
interrupted.
Disadvantages:
• Requires tight seal (Eating and talking
Difficult, Uncomfortable)
The non rebreather mask:
This mask provides the highest concentration of
oxygen 95 to 100% at a flow rate of. 6 to 15 liters
per minute.
• It is similar to the partial rebreather mask
except two one-way valves Prevents
conservation of exhaled air.
• The bag has an oxygen reservoir
• When the patient exhales air, the one way
was. Closes and all of the expired Aries.
Deposited into the atmosphere, not the
reservoir bag.
• In this way, the patient is not rebreathing
away of the expired gas.

During inhalation the bag deflates slightly and

expands fully on exhalation.
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Venturi Mask:
It is used primarily for patients with chronic
obstruction pulmonary disease.
• It is high flow oxygen delivery device
• Oxygen from 40 – 50% at liters flow of 4 to
15L/min

Advantages:
• Delivers most precise oxygen concentration
• Doesn’t dry mucus membrane
Disadvantages:
• Uncomfortable
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• Risk for skin irritation
Oxygen Hood:
• An oxygen hood is used for babies who can
breath on their own but still need extra oxygen.
• A hood is a plastic dome or box with warm
moist oxygen inside
• The hood is placed over the baby’s head.

Oxygen Tent:
✓ An oxygen tent consists of a canopy placed

over the head and shoulder or over the entire

body of a patient to provide oxygenate higher
level than normal.
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✓ Typically the tent is made of the through plastic
material
✓ It can envelop the patients head with the end
sections held in place by a matters to ensure that
the tent is air tight
✓ The encloser often has a side opening with a
zipper

Oxygen tent
Ambu Bag :
Artificial manual breathing unit (or) bag valve
mask ventilation.
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This is a hand held device commonly used to
provide positive pressure ventilation to patients who
are not breathing or not breathing adequately.

Ambu Bag
Tracheostomy collor/Mask:
✓ Inserted direct into trachea

✓ O2 flow rate is 8 – 10L

✓ Comfortable and more efficient

✓ Provides good humidity

T – Piece :
T – shaped tubing connected to an
endotracheal tube is used to deliver oxygen therapy in
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an intubated patient who does not require mechanical
ventilation. It gives high oxygen concentration to the
patient 8 – 10L/min.

Tracheostomy Collor/Mask

T – Piece
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General instructions:
• Oxygen should be treated as a drug, the five rights
of medication administration also pertain to
oxygen
• When using an oxygen cylinder or central supply
oxygen, use a regulator and humidifier
• Every part of the apparatus should be clean to
prevent infection
• Change nasal catheter at least every eight hours or
more often to prevent blockage of the nasal
catheter by a mucus plug
• When oxygen therapy is to be disconnected it
should be done gradually
• Pay attention to condition than can interfere with
the flow of oxygen from source to the patient. This
may include tubing loose connections that faulty
humidifying apparatus.
 • Always keep a spare oxygen cylinder in close
vicinity
• Watch the patients receiving oxygen therapy
continuously to detect the early sings of oxygen
toxicity Demonstration and
• Since oxygen supports combusting fire discussiom
precautions are to be taken when oxygen is on
flow, i.e., smoking use of matches, lighters etc.
Explain the PROCEDURE:
procedure of 12min Preparation of the patient:
O2 • Check name, bed no, and other identification
administration marks of the patient
• Check the diagnosis and the need for oxygen
therapy
• Check doctors orders for initiation of the therapy
and dosage
• Assess the patient for any signs of clinical anoxia
• Assess the patients vital signs and breathing
patterns carefully before starting therapy.
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• Explain the need of oxygen therapy, and the
sequence of the procedure
• Gain the patients confidence
• Keep the patient in a propped up or fowler’s
position
Preparation of Articles:
Oxygen cylinder with stand, central oxygen supply
with a flow meter, humidifier/walff’s bottle and
connecting tubing
A Tray Containing Rational
a) Nasal To deliver
catheter/cannula/oxygen oxygen
mask of an appropriate size
clean/type in a covered
container
b) Water soluble lubricating To lubricate the
jelly nasal catheter
c) Adhesive tape To attach it
Objective Time Content
d) A bowl of water To check oxygen flow
e) Swab sticks and normal saline in a container For cleaning nostrils
f) No smoking (Indicator) To take fire precautions
g) Humidifier bottle Prevents dryness

STEPS OF PROCEDURE
STEPS RATIONALE SCIENTIFIC NURSING
PRINCIPLE PRINCIPLE
Wash hands Reduces transmission of micro- Microbiology Safety
organisms soap and water, reduce
surface tension and thus remove
dirt and check the growth of micro
organisms
Attach the cannula/catheter mask to Prevents drying of nasal and oral Physics Safety,
oxygen tubing and humidified mucus membrane and airway comfort
oxygen source adjust to the flow rate secretions use of a humidifier
prevents drying of mucus
membrane
Objective Time Content
place tips of cannula into the Directs flow of oxygen into the Therapeutic
patients nares. If mask, apply upper respiratory tract. effectiveness,
snuggly to face Prevents loss of oxygen. economy of
material
check cannula/ equipment Ensures patency of cannula and Safety
every eight hours oxygen flow delivery of
prescribed oxygen
keep the humidifier jar filled at Prevents inhalation of Safety and
all times dehumidified oxygen prevents therapeutic
drying of mucus membranes effectiveness
observe the patients nares and Oxygen therapy can dry nasal Safety
superior surface of both ears mucosa pressure on ears from comfort
and skin breakdown cannula tubing/elastic can
cause skin irritation
check the oxygen flow rate and Ensures delivery of the Safety Therapeutic
the physicians orders every prescribed oxygen flow rate effectiveness
eight hours
Objective Time Content
Record procedure in the nurses Documents correct use of Safety, good
notes oxygen therapy and the patients workmanship
response

AFTER CARE :
After care of the patient and the articles
➢ Stay with the patient till he/she is at ease
➢ Keep the patient warm and comfortable
➢ Evaluate the patients progress by observing the vitals signs and symptoms
➢ Watch the patient for any deterioration symptoms after the removal of oxygen inhalation.
Inform to the doctor
➢ Record procedure with date and time
➢ Request for an arterial blood gas analysis at specified intervals to make sure hypnosis is
treated
➢ Take all articles to the utility area
➢ Clean nasal catheter with cold water, then warm soapy water and finally with clean water
➢ Boil or store or send for sterilization
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Conclusion :
In conclusion oxygen administration is a
common clinical intervention for patient with
respiratory distress oxygen therapy is also known as
supplemental oxygen optimizing outcome often
depends on selecting the correct.
Bibliography
1. Text book of Fundamentals of Nursing (TNAI)

A procedure manual, 2010 edition page no 491

– 498
2. Clinical nursing procedure the art of nursing

practice 5th edition page no 209 – 215

3. Mosbys manual of critical care Linda feiwell

abels, page no 161 – 166.