1. Lecture Notes on Oxygen Therapy
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
One way valves on the mask and between the reservoir bag
and the mask prevent the room air and the client’s exhaled air
from entering the bag so only the oxygen in the bag is inspired.
Venturi Mask
Delivers oxygen concentrations varying from 24% - 40% or
50% at liter flows of 4 – 10 L/min.
Has wide-bore tubing and color –coded jet adapters that
correspond to a precise oxygen concentration and liter flow
NURSING SKILLS
Face Tent
OXYGEN THERAPY Can replace oxygen mask when mask is poorly tolerated by
clients
Lecturer: Mark Fredderick R. Abejo RN,MAN Face tents provide varying concentrations of oxygen.
NOTE:
Administration of oxygen at greater than 21% (the Clients using face mask and face tent, frequently check
concentration of oxygen in room air) to provide adequate and inspect the client’s facial skin for dampness or chafing and
transport of oxygen in the blood, to decrease the work of dry and treat as needed.
breathing, and to reduce stress on the myocardium
Clients who have difficulty ventilating, those whose gas
exchange is impaired or people with heart failure may require Transtracheal Oxygen Delivery
oxygen therapy to prevent hypoxia.
May be used for oxygen dependent client.
Oxygen Delivery System Oxygen is delivered through a small, narrow plastic cannula
Nasal Cannula surgically inserted directly into the trachea.
Clients require less oxygen .5 – 2 L/min, because all of the
flow delivered enters the lungs
It delivers a relatively low concentration of oxygen (24% -
45% ) at flow rate of 2 – 6 L/min.
Simple Face Mask
It delivers oxygen concentrations from 40% - 60% at liter
flows of 5 - 8 L/min
Oxygen Therapy Safety Precautions
Partial Rebreather Mask
Place cautionary signs reading “ No SMOKING: Oxygen in
Delivers oxygen concentrations of 60% - 90% at liter flows of Use” on the client’s door at the foot or head of the bed and on
6 – 10 L/min. the oxygen equipment
The oxygen reservoir bag that is attached allows the client to Note:
Oxygen is colorless, odorless, tasteless and a dry gas
re-breathe about the first third of the exhaled air in conjunction
that support combustion, therefore leakage cannot be detected.
with oxygen.
Non- Rebreather Mask
Delivers the highest oxygen concentration possible 95% -
100% at liter flows of 10 – 15 L/min.
2. Lecture Notes on Oxygen Therapy
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
Instruct the client and visitors about the hazard of smoking
with oxygen in use.
Make sure that electric device are in good condition in order to
prevent the occurrence of short-circuit sparks.
Flow Meter with Humidifier
Avoid materials that generate static electricity, such as woolen
blankets and synthetic fibers. Cotton blankets should be used.
Avoid the use of volatile, flammable materials such as oils,
greases, alcohol and acetone near clients receiving oxygen.
Make known the location of fire extinguishers
Administering Oxygen by Cannula, Face Mask or Face Tent
Flow Meter and Adapter
Purposes:
Cannula To deliver a relatively low concentration
of O2 when only minimal O2 support is
required.
To allow uninterrupted delivery of
oxygen while the client ingest food or
fluids.
Face Mask To provide moderate O2 support and a
higher concentration of oxygen or
humidity than is provided by cannula.
Face Tent To provide high humidity
To provide O2 when a mask is poorly Oxygen Humidifier attached to a wall-outlet oxygen flow
tolerated.
To provide a high flow of 02 when
attached to a Venturi system.
Equipment:
Cannula
- Oxygen supply with a flow meter and adapter
- Humidifier with distilled/sterile water
- Nasal Cannula and Tubing
Face Mask
- Oxygen supply with a flow meter and adapter
- Humidifier with distilled/sterile water
- Prescribed face mask of the appropriate size
- Padding for the elastic band
Face Tent
- Oxygen supply with a flow meter and adapter
- Humidifier with distilled/sterile water
- Face tent of the appropriate size
3. Lecture Notes on Oxygen Therapy
Prepared By: Mark Fredderick R Abejo R.N, MAN
Clinical Instructor
Steps / Procedure Rationale
Assessment: Determine the need for
Assess oxygen therapy and verify
Skin and Mucous membrane color: Note whether cyanosis is doctor’s order.
present. Identify and inform the
client and explain the To allay anxiety
Breathing Pattern Alteration procedure.
Rate: Assist the client to a semi- Permits easier chest expansion
Tachypnea – Rapid RR fowler’s position if possible. and breathing
Wash hands and observe
Bradypnea – Slow RR appropriate infection control
Apnea – Cessation of breathing Set up the oxygen
equipment and the
Volume: humidifier filled with
distilled/sterile water
Hyperventilation - Excessive amount of
inspired air in the lungs.
- Deep rapid respirations. - Attach the flow meter to the To prevent air leakage
Hypoventilation - Dec. rate/ depth of resp. wall or tank. The flow meter
- Excessive CO2 retention should be in the off position.
Rhythm: - Attach the humidifier bottle to
the base of the flow meter
Cheyne-stokes – marked rhythmic waxing and waning of
respiration from very deep to very shallow breathing and - Attach the O2 tubing
temporary apnea. Turn on the oxygen at the
Kussmaul’s – Increased rate and depth of breathing to remove prescribed rate and ensure
excess CO2 in the lungs. proper functioning
Apneustic – Prolong gasping inspiration followed by a very
short, usually inefficient expiration.
Apply the appropriate
Biot’s – Shallow breaths interrupted by apnea
devices
Ease of Effort
Dyspnea – Difficullty or labored breathing CANNULA
- Put over the client’s face, with
Orthopnea – Inability to breath except in upright or sitting
the outlet prongs fitting into the
position.
nares.
Chest movement FACE MASK
- Fit the mask to the contours of
Lung sound the client’s face, apply it from So that very little of O2 escapes
the nose downward around the cheeks and chin
Sign of Hypoxemia
- tachycardia ( early sign ) FACE TENT
- tachypnea - Place the tent over the client’s
- restlessness face
- dyspnea
- cyanosis
- confusion ( late sign ) Assess client regularly * Clients using face mask and
NOTE: face tent,
Sign of Hypercapnia (Excess CO2) * Client using cannula, check frequently check and inspect the
- restlessness the nares for irritation, apply client’s facial skin for
- HPN water sol.lubricant as needed dampness or chafing and dry
- Headache and treat as needed.
- lethargy
- tremor Inspect equipment regularly
Document relevant
Sign of Oxygen Toxicity information
- tracheal irritation
- substernal discomfort
- cough
- dyspnea
- paresthesia
- dec. pulmonary ventilation