Administering O2 Therapy

ADMINISTERING OXYGEN
THERAPY
I. DEFINITION
Oxygen Therapy – is the administration of oxygen at a
concentration of pressure greater than that found in the
environmental atmosphere.
II. RATIONALE
1. To increase oxygenation in client with reduced blood oxygen-
carrying capacity.
2. To enable the client to reduce his ventilator efforts in a
respiratory emergency.
3. To boost alveolar oxygen levels when lung volumes are
decreased from alveolar hypoventilation such as in cases
of atelectasis or ARDS.
4. To help meet the increased myocardial workload as the heart
tries to compensate for hypoxemia in a cardiac emergency.
5. To supply the body with enough oxygen to meet its cellular
needs when metabolic demand is high (in cases of massive
trauma, burns, or high fever).
III. EQUIPMENT
1. Stethoscope with low flow rates per nasal
2. Oxygen delivery device: cannula)
- nasal cannula 5. Oxygen source – portable
- mask or in-line
- T-tube with adapter for 6. Oxygen flow meter
artificial airway. 7. Pulse oximetry
3. Oxygen tubing
4. Humidifier and distilled or
sterile water (not needed
NASAL CANNULA FACE MASK WITH TUBING
STETHOSCOPE
T-TUBE WITH ADAPTER FOR ARTIFICIAL AIRWAY

O2 REGULATOR
O2 FLOW METER PORTABLE OXYGEN WITH FLOW METER
AND HUMIDIFIER
TYPES OF O2 MASKS HUMIDIFIER SET
NON-REBREATHER
STERILE WATER
VENTURI HIGH FLOW
DEVICE SET
OXYGEN TANKS
IV. PLANNING AND IMPLEMENTATION
ACTION RATIONALE
1. Obtain preliminary
information:
 Determine client history and  To determine the need for O2
acute or chronic health therapy and to develop baseline
problems. data if not already available.
 Assess the client’s baseline  To determine the client’s need
respiratory signs; including for oxygen as well as response
airway, respiratory pattern, to the therapy.
depth, and rhythm, noting
indications of increased work or
breathing.
 Review ABG and pulse oximetry  To determine the need for
results. therapy as well as changes in
therapy. ABG and pulse
ACTION RATIONALE
oximetry are the most important
determinant s of the effectiveness of
the pulmonary system.
 Note lung sounds for

 To look for signs of irritation or
wheezes/crackles. Secretions will
breakdown.
interfere with airway patency.
 Assess nares behind the earlobes,
cheeks, tracheostomy site, or  To ensure correct dosage and
other places where oxygen tubing route.
or equipment is in constant
contact with the skin.
 The prescribing practitioner’s
order for O2 including the
administering device and the liter
flow rate (L/min).
ACTION RATIONALE
2. Give adequate explanation and  To increase compliance with
reassurance to the client and procedure.
support persons.
3. Assist the client to a semi fowler’s  To permit easier chest expansion
position if possible. and hence easier breathing.
4. Obtain equipment needed.
5. Wash hands before assembling  To reduce transmission of
the equipment. microorganism to the client.
6. Attach “No Smoking Oxygen In  To avoid any activity that might
use.” signs are placed on the cause spark or fire since oxygen is
client’s door, at the foot or head combustible.
of the bed, and O2 equipment.
Explain hazards to the client.
7. If using humidity, fill humidifier to
fill line with distilled water and  To prevent drying of the client’s
close container. airway.
ACTION RATIONALE
8. Attach humidifier to oxygen flow  To allow the oxygen to pass

meter. through the water and become
humidified.
9. Insert humidifier and flow meter  To gain access to oxygen. Many
into oxygen source in wall or institutions also have compressed
portable unit. air available from outlets very
similar in appearance to oxygen
10. Check the equipment if it is outlets.
functioning well.
 There should be no kinks in the  To ensure safe and effective O2
tubing. administration.
 The connection should be air  To ensure proper functioning.
tight.
ACTION RATIONALE
 There should be bubbles in the  To check for patency of the

humidifier as the O2 flows thru catheter.
the H2O.
 You should feel the O2 at the

outlets of cannula.
11. Administer Oxygen

ACTION RATIONALE
NASAL CANNULA
1. Attach the oxygen tubing and  To prevent drying of the nasal
nasal cannula to the flow meter mucosa, flow rate should not
and turn it on to the prescribed exceed 6L/min when administering
flow rate (1-5 L/min). Use oxygen via nasal cannula.
extension tubing for ambulatory
clients so they can get up to go to
the bathroom.
2. Place the nasal prongs in the  To deliver the amount of oxygen
client’s nostrils. Secure the ordered and keep delivery system
cannula in place by adjusting the in place.
tubing around the client’s ears
and using the slip ring to stabilize
it under the client’s chin.
3. Check for proper flow rate every 4  To ensure that the client
hours. receives proper dose.
ACTION RATIONALE
4. Assess client’s nostrils every 8  To prevent drying of the mucous
hours. If the client complains of membrane. Dry membranes are
dryness or has signs of irritation, more prone to breakdown by
use sterile lubricant to keep friction or pressure from nasal
mucous membranes moist. Add cannula.
humidifier if not already in place.
5. Monitor vital signs, oxygen  To detect any untoward effects

saturation, and client condition from therapy.
every 4-8 hours (or as indicated
or ordered) for signs and
symptoms of hypoxia.
6. Wean client from oxygen as soon

as possible using standard
protocols.
ACTION RATIONALE
MASK: Venturi (High-flow device),
Simple mask (Low flow), Partial
rebreather mask, Non rebreather
mask and Face tent.
1. Attach appropriate sized mask or  To ensure proper fit; size needed is
face tent to oxygen tubing, and based on the client’s size.
turn on flow meter to prescribed
flow rate.
a. The Venturi mask will have color-
coded inserts that list the flow.
b. Rate necessary to obtain the
desired percentage of oxygen.
c. Allow the reservoir bag of the
non-rebreathing or partial
rebreathing mask to fill
completely.
ACTION RATIONALE
2. Place the mask or tent on the  To prevent loss of oxygen from the
client’s face, fasten the elastic sides of the mask.
band around the client’s ears, and
tighten until the mask fit snugly.
3. Check the proper flow rate every
4 hours.
4. Ensure that the ports of the
 To provide client comfort and
Venturi mask are not under covers
prevent skin breakdown.
or impeded by any other source.
5. Assess the client’s face and ears
for pressure from the mask, and
use padding as needed.
6. Wean client to nasal cannula and
then wean off oxygen per
protocol.
ACTION RATIONALE
OXYGEN VIA ARTIFICIAL AIRWAY
(Tracheostomy or Endotracheal tube)
1. Attach the wide bore oxygen  To check the oxygen source and
tubing and T-tube adapter or prime the tubing and adapter.
tracheostomy mask to the flow
meter and turn the meter to the
flow rate needed to achieve the
prescribed oxygen concentration.
 An oxygen analyzer may be used to
check the actual oxygen percentage
being delivered.
2. Check for bubbling in the  To ensure proper functioning.
humidifier and a fine mist from
the adapter.
3. Attach the T-piece to the client’s  To ensure that the client will not
artificial airway or place the mask develop complications related to
ACTION RATIONALE
over the client’s airway. Be sure the an interrupted oxygen supply.
T-piece is firmly attached to the
airway.
4. Position tubing so that it is not  To provide comfort and prevent
pulling client’s airway. dislodgment of the artificial airway.
5. Check for proper flow rate and  To ensure that client is receiving
patency of the system every 1 to 2 proper dose.
hours depending on the acuity of
the client.
6. Suction as needed to maintain a  To detect response to or any

patent airway. untoward effects from therapy.
ACTION RATIONALE
7. Monitor airway patency, vital  To determine whether tube is in
signs, oxygen saturation, and for place.
signs and symptoms of hypoxia
every 2 hours, or more
frequently as necessary or as
ordered. Additionally, monitor
breath sounds and tube position
every 4 hours.
V. EVALUATION
1. Oxygen levels returned to normal in blood and tissues as evident by

oxygen saturation is equal or greater than 92%; skin color normal for
client.
2. Respiratory rate, pattern, and depth are within the normal range.
3. The client did not develop any skin or tissue irritation or breakdown.
4. Breathing efficiency and activity tolerance are increased.
5. The client understands the rationale for the therapy.

VI. DOCUMENTATION
1. Record O2 saturation and respiratory status.
2. Note method of oxygen delivery rate.
3. Document client’s assessment parameters and response to

treatment.
4. Note and record changes in mental status.

“In the long run we shape our lives, and we shape
ourselves. The process never ends till the end of life.
And the choices we make are ultimately our own
responsibility.”
- Eleanor Roosevelt
-END-

Administering O2 Therapy

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ADMINISTERING OXYGEN

T-TUBE WITH ADAPTER FOR ARTIFICIAL AIRWAY

 Note lung sounds for

8. Attach humidifier to oxygen flow  To allow the oxygen to pass

 There should be bubbles in the  To check for patency of the

 You should feel the O2 at the

11. Administer Oxygen

5. Monitor vital signs, oxygen  To detect any untoward effects

6. Wean client from oxygen as soon

6. Suction as needed to maintain a  To detect response to or any

1. Oxygen levels returned to normal in blood and tissues as evident by

4. Breathing efficiency and activity tolerance are increased.

5. The client understands the rationale for the therapy.

1. Record O2 saturation and respiratory status.

2. Note method of oxygen delivery rate.

3. Document client’s assessment parameters and response to

4. Note and record changes in mental status.

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