CHAPTER 10 RESPIRATORY FUNCTION AND THERAPY

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ADMINISTERING
PROCEDURE OXYGEN
GUIDELINES BY NASAL CANNULA CONTINUED
10-14

Nursing Action
Rationale
FOLLOW-UP PHASE
1. Record flow rate used and immediate
patient response. 1. Note the patient’s tolerance of treatment.
2. Assess patient’s condition, ABG or Sao 2 Report any intolerance noted.
and the functioning of equipment at 2. Depression of hypoxic drive is most likely
regular intervals. to occur within the first hours of oxygen
use. Monitoring of Sao2 with oximetry can
be substituted for ABG if the patient is not
3. Determine patient comfort with oxygen retaining CO2
use. 3. Flow rates in excess of 4 L/min may
cause irritation to the nasal and
pharyngeal mucosa.
NURSING ALERT
Avoid use of petroleum jelly to lubricate nares, because it may clog openings of cannula

ADMINISTERING
PROCEDURE OXYGEN
GUIDELINES BY SIMPLE FACE MASK
10-15
WITH/WITHOUT AEROSOL

EQUIPMENT
Oxygen source Plastic aerosol mask NO SMOKING signs
Humidifier bottle with distilled water, Large-bore tubing (high humidity) or small-bore tubing For heated aerosol therapy:
If high humidity is desired Flowmeter Humidifier heating element
PROCEDURE

Nursing Action
Rationale
PREPARATORY PHASE
1. Determine current vital signs, level of
consciousness, and Sao2 or ABG, if 1. Because the nebulizer face mask is a low
patient is at risk for CO2 retention. flow system (patient’s tidal volume may
supply part of inspired gas), oxygen
concentration will vary depending on the
patient’s respiratory rate and rhythm.
Oxygen delivery may be inadequate for
tachypneic patients (flow does not meet
peak inspiratory demand) or excessive for
2. Assess viscosity and volume of sputum patients with slow respirations.
produced. 2. Aerosol is given to assist in mobilizing
retained secretions.

PERFORMANCE PHASE
1. Post NO SMOKING signs on patient’s
door and in view of the patient and
visitors.
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2. Show the aerosol mask to the patient and

explain the procedure.
3. Make sure the humidifier is filled to the 3. If the humidifier bottle is not sufficiently
appropriate mark. full, less moisture will be delivered.
4. Attach the large-bore tubing from the
mask to the humidifier in the heating
element, if used.
5. Set desired oxygen concentration 5. The inspired oxygen concentration is
humidifier bottle and plug in the heating determined by the humidifier setting.
element, if used. Usual concentrations are 35% to 50%
6. If the patient is tachypneic and 6. The aerosol mask is a low-flow system.
concentration of 50% oxygen or greater is Yoking two humidifiers together doubles
desired, two humidifiers and flow meters humidifier flow but does not change the
should be yoked together. inspired oxygen concentration.
7. Adjust the flow rate until the desired mist 7. This ensures that the patient is receiving
is produced (usually 10 to 12 L/min). flow sufficient to meet inspiratory demand
and maintains a constant accurate
concentration of oxygen.