NCM 109 RLE – CARE OF MOTHER, CHILD, AT RISK OR WITH PROBLEMS (ACUTE AND CHRONIC)

OXYGEN INHALATION

DEFINTION:
It involves breathing oxygen in a pressurized chamber or tube. This allows the lungs to gather up
to three times more oxygen than by breathing oxygen at normal air pressure. The extra oxygen
moves through the blood and to the organs and body tissues. It can be administered by Cannula,
Face Mask, or Face Tent.

PURPOSES:
Nasal Cannula
• To deliver a relatively low concentration of oxygen when only minimal oxygen support is
required.
• To allow uninterrupted delivery of oxygen while the client ingest food or fluids.
Face Mask
• To provide moderate oxygen support & a higher concentration of oxygen and/or humidity
than is provided by cannula.
Tent
• To provide high humidity.
• To provide oxygen when a mask is poorly tolerated.
• To provide a high flow of oxygen when attached to a venturi system.

PRINCIPLES:
• Secure and maintain airway patency.
• Enhance circulation.
• Avoid reverse respiratory depressants.
EQUIPMENT:
Nasal Cannula
• Oxygen supply with a flow meter & adapter.
• Humidifier with distilled water or tap water according to agency protocol.
• Nasal cannula & tubing.
• Tape
• Padding for the elastic band.
Face Mask
• Oxygen supply with a flow meter & adapter
• Humidifier with distilled water or tap water according to agency protocol
• Prescribed face mask of appropriate size
• Padding for the elastic band
Tent
• Oxygen supply with a flow meter & adapter
• Humidifier with distilled water or tap water according to agency protocol
• Face tent of the appropriate size

PROCEDURE (Action) RATIONALE

1. Bring necessary equipment to the To save time & energy.
bedside stand or overbed table.

2. Explain the procedure to patient & To gain patient’s cooperation & avoid
review safety precautions necessary combustion. Oxygen supports combustion.
when oxygen is in use. Place “No
Smoking” signs in appropriate areas.
3. Perform hand hygiene & put on PPE if To deter the spread of microorganisms.
indicated.
4. Identify the patient. To be sure you got the right patient.
5. Close curtains around bed and close To maintain privacy.
the door to the room, if possible.

Nasal Cannula
6. Connect nasal cannula to oxygen setup Oxygen forced through a water reservoir is
with humidification if one is in use. humidified before it is delivered to the
Adjust flow rate as ordered by patient, thus preventing dehydration of the
physician. Check that oxygen is flowing mucous membranes. Low-flow O2 does not
out of prongs. require humidification.
7. Place prongs in patient’s nostrils. Place Correct placement of prongs & fastener
tubing over and behind each ear with facilitates O2 administration & patient
adjuster comfortably under chin. comfort.
Alternately, the tubing may be placed
around the patient’s head, with the
adjuster at the back or base of the
head. Place gauze pads at ear beneath
the tubing, as necessary.
 8. Place gauze pads at ear beneath the
tubing & adjust the fit of the cannula,
as necessary. Tubing should be snug
but not tight against the skin.
9. Encourage patient to breathe
through the nose, with the mouth
closed.
10. Remove & clean the cannula & assess
nares at least every 8 hours, or
according to the agency
recommendations. Check nares for
evidence of irritation or bleeding.
Face Mask
11. Attach face mask to oxygen source
(with humidification, if appropriate,
for the specific mask). Start the flow
of oxygen at the specified rate. For a
mask with a reservoir, be sure to
allow oxygen to fill the bag before
proceeding to the next step.
12. Position face mask over the patient’s
nose and mouth. Adjust the elastic
strap so that the mask fits snugly but
comfortably on the face. Adjust the
flow rate to the prescribed rate.
13. Use gauze pads under the elastic Pads reduce irritation & pressure & protect
strap at pressure points to reduce the skin.
irritation to ears and scalp.
14. Remove the mask and dry the skin
every 2 to 3 hours if the oxygen is
running continuously. Do not use
powder around the mask.
Tent
15. Place tent over crib or bed. Connect
the humidifier to the oxygen source
in the wall and connect the tent
tubing to the humidifier. Adjust flow
Pads reduce irritation & pressure & protect
the skin.
Nose breathing provides for optimal delivery
of oxygen to patient.
The continued presence of the cannula causes
irritation & dryness of the mucous
membranes. Water-soluble lubricants
counteract the drying effects of O2.
O2 forced through a water reservoir is
humidified before it is delivered to the
patient, thus preventing dehydration of
mucous membranes. A reservoir bag must be
inflated with O2 because the bag is the source
of oxygen supply for the patient.
A loose or poorly fitting mask will result in
oxygen loss & decreased therapeutic value.
Masks may cause a feeling of suffocation, &
the patient needs frequent attention &
reassurance.
The tight-fitting mask & moisture from
condensation can irritate the skin on the face.
There is a danger of inhaling powder if it is
placed on the mask.
O2 forced through a water reservoir is
humidified before it is delivered to the
patient, thus preventing dehydration of
mucous membranes.
 rate as ordered by physician. Check
that oxygen is flowing into tent.

16. Turn analyzer on. Place oxygen The analyzer will give an accurate reading of
analyzer probe in tent, out of the concentration of oxygen in crib or bed.
patient’s reach.

17. Adjust oxygen as necessary, based Patient will receive O2 once placed in the tent.
on sensor readings. Once oxygen
levels reach the prescribed amount,
place patient in the tent.

18. Roll small blankets like a jelly roll The blanket helps keep the edges of the tent
and tuck tent edges under blanket flap from coming up & letting oxygen out.
rolls, as necessary.

19. Encourage patient and family Every time the tent flap is opened, O2 is
members to keep tent flap closed. released.

20. Frequently check bedding & patient’s The large amount of humidification delivered
pajamas for moisture. in an O2 tent quickly makes cloth moist, which
would be uncomfortable for the patient.
For any method
21. Reassess patient’s respiratory Patient’s respiratory rate & pattern, color,
status, including respiratory rate, chest movements, & so forth indicate
effort, and lung sounds. Note any effectiveness of O2 therapy.
signs of respiratory distress, such as
tachypnea, nasal flaring, use of
accessory muscles, or dyspnea.

22. Remove PPE, if used. Perform hand To deter the spread of microorganisms.
hygiene.

23. Document amount of O2 applied, Documentation ensures continuity of care &

respiratory rate, oxygen saturation, & ongoing assessment record.
lung sounds.

REFERENCES:

Kozier, Barbara. Fundamentals of Nursing. 7th Edition, Pearson Educational South Asia Pte Ltd.
2004.
Smith, Pamela. Taylor’s Clinical Nursing Skills. 5th Edition, Lippincott Williams & Wilkins. 20005.
 NCM 109 RLE – CARE OF MOTHER, CHILD, AT RISK OR WITH PROBLEMS (ACUTE AND CHRONIC)
PERFORMANCE RATING SCALE
OXYGEN INHALATION

SCALE DESCRIPTION INDICATORS

4 Very Good Student performs behaviors/tasks reflecting the highest level of
performance: consistent, independent, effective
3 Good Student performs behaviors/tasks reflecting mastery of performance
with minimal supervision
2 Fair Student performs behaviors/tasks reflecting development and
movement towards mastery of performance with help or direct
supervision in some aspect
1 Needs Student performs behaviors/tasks reflecting beginning level of
Improvement performance; tasks not done properly majority of the time but
demonstrate understanding of concepts involved with tasks

DEFINTION:
It involves breathing oxygen in a pressurized chamber or tube. This allows the lungs to gather up
to three times more oxygen than by breathing oxygen at normal air pressure. The extra oxygen
moves through the blood and to the organs and body tissues. It can be administered by Cannula,
Face Mask, or Face Tent.

PURPOSES:
Nasal Cannula
• To deliver a relatively low concentration of oxygen when only minimal oxygen support is
required.
• To allow uninterrupted delivery of oxygen while the client ingest food or fluids.
Face Mask
• To provide moderate oxygen support & a higher concentration of oxygen and/or humidity
than is provided by cannula.
Tent
• To provide high humidity.
• To provide oxygen when a mask is poorly tolerated.
• To provide a high flow of oxygen when attached to a venturi system.
PRINCIPLES:
• Secure and maintain airway patency.
• Enhance circulation.
• Avoid reverse respiratory depressants.

EQUIPMENT:
Nasal Cannula
• Oxygen supply with a flow meter & adapter.
• Humidifier with distilled water or tap water according to agency protocol.
• Nasal cannula & tubing.
• Tape
• Padding for the elastic band.

Face Mask
• Oxygen supply with a flow meter & adapter
• Humidifier with distilled water or tap water according to agency protocol
• Prescribed face mask of appropriate size
• Padding for the elastic band
Tent
• Oxygen supply with a flow meter & adapter
• Humidifier with distilled water or tap water according to agency protocol
• Face tent of the appropriate size

PROCEDURE 4 3 2 1 REMARKS
1. Bring necessary equipment to the bedside stand or overbed
table.
2. Explain the procedure to patient & review safety precautions
necessary when oxygen is in use. Place “No Smoking” signs in
appropriate areas.
3. Perform hand hygiene & put on PPE if indicated.
4. Identify the patient.
5. Close curtains around bed and close the door to the room, if
possible.
Nasal Cannula
6. Connect nasal cannula to oxygen setup with humidification if
one is in use. Adjust flow rate as ordered by physician. Check
that oxygen is flowing out of prongs.
7. Place prongs in patient’s nostrils. Place tubing over and behind
each ear with adjuster comfortably under chin. Alternately,
the tubing may be placed around the patient’s head, with the
adjuster at the back or base of the head. Place gauze pads at
ear beneath the tubing, as necessary.
 8. Place gauze pads at ear beneath the tubing & adjust the fit of
the cannula, as necessary. Tubing should be snug but not tight
against the skin.
9. Encourage patient to breathe through the nose, with the
mouth closed.
10. Remove & clean the cannula & assess nares at least every 8
hours, or according to the agency recommendations. Check
nares for evidence of irritation or bleeding.
Face Mask
11. Attach face mask to oxygen source (with humidification, if
appropriate, for the specific mask). Start the flow of oxygen
at the specified rate. For a mask with a reservoir, be sure to
allow oxygen to fill the bag before proceeding to the next
step.
12. Position face mask over the patient’s nose and mouth.
Adjust the elastic strap so that the mask fits snugly but
comfortably on the face. Adjust the flow rate to the
prescribed rate.
13. Use gauze pads under the elastic strap at pressure points to
reduce irritation to ears and scalp.
14. Remove the mask and dry the skin every 2 to 3 hours if the
oxygen is running continuously. Do not use powder around
the mask.
Tent
15. Place tent over crib or bed. Connect the humidifier to the
oxygen source in the wall and connect the tent tubing to the
humidifier. Adjust flow rate as ordered by physician. Check
that oxygen is flowing into tent.
16. Turn analyzer on. Place oxygen analyzer probe in tent, out
of patient’s reach.
17. Adjust oxygen as necessary, based on sensor readings. Once
oxygen levels reach the prescribed amount, place patient in
the tent.
18. Roll small blankets like a jelly roll and tuck tent edges under
blanket rolls, as necessary.
19. Encourage patient and family members to keep tent flap
closed.

20. Frequently check bedding & patient’s pajamas for moisture.

For all method
21. Reassess patient’s respiratory status, including respiratory
rate, effort, and lung sounds. Note any signs of respiratory
distress, such as tachypnea, nasal flaring, use of accessory
muscles, or dyspnea.
22. Remove PPE, if used. Perform hand hygiene.
23. Document amount of O2 applied, respiratory rate, oxygen
saturation, & lung sounds.
TOTAL /
 Actual Score/Total Score x 100

A (92 – 100)
A- (84 – 91.99)
B (76 – 83.99)
B- (68 – 75.99)
C (60 – 67.99)
F (< 60)

Student’s Signature : ________________________

Clinical Instructor’s Signature : ________________________