OXYGEN ADMINISTRATION ➢To provide a high flow of O2 when

attached to a Venturi system

Administering Oxygen by Cannula and Face
Mask, or Face Tent PURPOSES: FACE TENT

Before administering oxygen, check THE  To provide high humidity

FOLLOWING:  To provide oxygen when a mask is

 the order for oxygen, including the poorly tolerated

administering device and the liter ASSESSMENT

flow rate (L/min) or the percentage
1. Skin and mucous membrane color: Note
of oxygen;
whether cyanosis is present, presence of
 the levels of oxygen (PaO2) and
mucus, sputum production, and impedance
carbon dioxide (PaCO2) in the
of airflow.
client’s arterial blood (PaO2 is
normally 80 to Administering Oxygen 2. Breathing patterns: Note depth of
by Cannula, Face Mask respirations and presence of tachypnea,
 whether the client has COPD. Note: bradypnea, or orthopnea
If the client has not had arterial
3. Chest movements: Note whether there
blood gases ordered, oxygen
are any intercostal, substernal,
saturation should be checked using
suprasternal, supraclavicular, or tracheal
a non-invasive oximeter
retractions during inspiration or expiration
PURPOSES: CANNULA
4. Chest wall configuration (e.g., kyphosis,
 To deliver a relatively low unequal chest expansion, barrel chest).
concentration of oxygen when only
5. Lung sounds audible by auscultating the
minimal O2 support is required.
chest and by ear.
 To allow uninterrupted delivery of
6. Presence of clinical signs of hypoxemia:
oxygen while the client ingests food
tachycardia, tachypnea, restlessness,
or fluids
dyspnea, cyanosis, and confusion.
PURPOSES: FACE MASK Tachycardia and tachypnea are often early

➢ To provide moderate O2 support and a signs. Confusion is a later sign of severe

higher concentration of oxygen and/or oxygen deprivation.

humidity than is provided by cannula

7. Presence of clinical signs of hypercarbia 1. Oxygen supply with a flow meter and
(hypercapnia): restlessness, hypertension, adapter 2.Humidifier with distilled water or
headache, lethargy, tremor. tap water according to agency protocol

8. Presence of clinical signs of oxygen 3. Nasal cannula and tubing

toxicity: tracheal irritation and cough,
4. Tape (optional)
dyspnea, and decreased pulmonary
ventilation 5. Padding for the elastic band

Determine: Face Mask

 Vital signs, especially pulse rate and 1.Oxygen supply with a flow meter and
quality, and respiratory rate, rhythm, adapter 2.Humidifier with distilled water or
and depth. tap water according to agency protocol
 Whether the client has COPD. A 3.Prescribed face mask of the appropriate
high carbon dioxide level in the size 4.Padding for the elastic band
blood is the normal stimulus to
Face Tent: Used in clients who cannot
breathe. However, people with
tolerate masks. Provide 30% to 50% O2
COPD may have a chronically high
concentration at a flow rate of 4 to 8L/min
carbon dioxide level, and their
stimulus to breathe is hypoxemia. ➢ Oxygen supply with a flow meter and
During continuous oxygen
adapter ➢ Humidifier with distilled water or
administration, arterial blood gas
tap water according to agency protocol
levels of oxygen (PaO2) and carbon
dioxide (PaCO2) are measured ➢ Face tent of the appropriate size
periodically to monitor hypoxemia.
Preparation
 Results of diagnostic studies such
as chest x-ray. 1. Determine the need for oxygen therapy,

 Hemoglobin, hematocrit, and and verify the order for the therapy.

complete blood count. 2. Perform a respiratory assessment to

 Oxygen saturation levels. develop baseline data if not already

 Arterial blood gases levels, if available.

available. 3. Prepare the client and support people.

 Pulmonary function tests, if available a. Assist the client to a semi-Fowler’s

position if possible.
Equipment: Cannula
Rationale: This position permits easier and caregivers should be advised to
chest expansion and hence easier wear cotton fabrics.
breathing. - Avoid the use of volatile, flammable
b. Explain that oxygen is not materials, such as oils, greases,
dangerous when safety precautions alcohol, ether, and acetone (eg. Nail
are observed. Inform the client and polish remover), near clients
support people about the safety receiving oxygen.
precautions connected with oxygen - Be sure that electric monitoring
use equipment, suction machines, and
- For home oxygen use or when the portable diagnostic machines are all
facility permits smoking, teach electrically grounded.
family members and roommates to - Make known the location of fire
smoke only outside or in provided extinguishers, and make sure
smoking rooms away from the client personnel are trained in their use.
and oxygen equipment.
PERFORMANCE
- Place cautionary signs reading “No
Smoking: Oxygen in Use” on the 1. Prior to performing the procedure,
client’s door, at the foot or head of introduce self and verify the client’s
the bed, and on the oxygen identity using agency protocol.
equipment. Explain to the client what you are
- Instruct the client and visitors about going to do, why is it necessary,
the hazard or smoking with oxygen and how he or she can participate.
in use. Discuss how the effects of the

- Make sure that electric devices oxygen therapy will be used in

(such as razors, hearing aids, planning further care or

radios, televisions, and heating treatments.

pads) are in good working order to

prevent the occurrence of short- 2. Perform hand hygiene and observe

circuit sparks. other appropriate infection

- Avoid materials that generate static prevention procedures.

electricity, such as wooden blankets 3. Provide client privacy, appropriately.

and synthetic fabrics. Cotton 4. Setting up the oxygen equipment

blankets should be used, and clients and the humidifier:

a. Attach the flow meter to the
 wall outlet or tank. The flow ease of respirations, and
meter should be in the off provides support while the
position. client adjusts to the devices.
b. If needed, fill the humidifier b. Assess the client in 15 to 30
bottle. (done before coming to minutes, depending on the
the bedside) client's condition.
c. Attach the humidifier bottle to c. Assess the client regularly for
the base of the flow meter. clinical signs of hypoxia,
d. Attach the prescribed oxygen tachycardia, confusion,
tubing and delivery device to dyspnea, restlessness, and
the humidifier. cyanosis.
5. Turn on the oxygen at the 8. Assessment for Nasal Cannula:
prescribed rate and ensure proper a. Assess the client's nares for
functioning. encrustations and irritation.
a. Check that the oxygen is b. Apply a water-soluble lubricant as
flowing freely through the required to soothe the mucous
tubing. membranes.
b. Set the oxygen at the flow rate c. Assess the top of the client's ears
ordered. for any signs of irritation from the
6. Application of the appropriate cannula tubing. If present, padding
oxygen delivery device: with a gauze pad may help relieve
a. Put the cannula over the client's the discomfort.
face, with the outlet prongs
fitting into the nares and the 9. Inspect the equipment on a regular
tubing hooked around the ears. basis.
b. If the cannula will not stay in a. Check the liter flow and whenever
place, tape it at the sides of the providing care to the client.
face. b. Be sure that water is not collecting
c. Pad the tubing and band over in dependent loops of the tubing
the ears and cheekbones as c. Make sure that safety precautions
needed. are being followed.
7. Assessment of the client, 10. Document findings in the client
a. Assess the client's vital signs, record using forms or checklists
level of anxiety, color, and supplemented by narrative notes
when appropriate.