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
2. Oxygen delivery device:
- nasal cannula
- mask
- T-tube with adapter for
artificial airway.
3. Oxygen tubing
4. Humidifier and distilled or
sterile water (not needed
with low flow rates per nasal
cannula)
5. Oxygen source – portable
or in-line
6. Oxygen flow meter
7. Pulse oximetry
 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
1. Obtain preliminary
information:
 Determine client history and
acute or chronic health
problems.
 Assess the client’s baseline
respiratory signs; including
airway, respiratory pattern,
depth, and rhythm, noting
indications of increased work or
breathing.
 Review ABG and pulse oximetry 
results.
RATIONALE
 To determine the need for O2
therapy and to develop baseline
data if not already available.
 To determine the client’s need
for oxygen as well as response
to the therapy.
To determine the need for
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
2. Give adequate explanation and 
reassurance to the client and
support persons.
3. Assist the client to a semi fowler’s 
position if possible.
4. Obtain equipment needed.
5. Wash hands before assembling 
the equipment.
6. Attach “No Smoking Oxygen In 
use.” signs are placed on the
client’s door, at the foot or head
of the bed, and O2 equipment.
Explain hazards to the client.
7. If using humidity, fill humidifier to
fill line with distilled water and 
close container.
RATIONALE
To increase compliance with
procedure.
To permit easier chest expansion
and hence easier breathing.
To reduce transmission of
microorganism to the client.
To avoid any activity that might
cause spark or fire since oxygen is
combustible.
To prevent drying of the client’s
airway.
 ACTION RATIONALE

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

meter.
9. Insert humidifier and flow meter  To gain access to oxygen. Many
into oxygen source in wall or
portable unit.
10. Check the equipment if it is
functioning well.
 There should be no kinks in the
tubing.
 The connection should be air
tight.
through the water and become
humidified.
institutions also have compressed
air available from outlets very
similar in appearance to oxygen
outlets.
 To ensure safe and effective O2
administration.
 To ensure proper functioning.
 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
4. Assess client’s nostrils every 8
hours. If the client complains of
dryness or has signs of irritation,
use sterile lubricant to keep
mucous membranes moist. Add
humidifier if not already in place.
RATIONALE
 To prevent drying of the mucous
membrane. Dry membranes are
more prone to breakdown by
friction or pressure from nasal
cannula.

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
over the client’s airway. Be sure the
T-piece is firmly attached to the
airway.
4. Position tubing so that it is not
pulling client’s airway.
RATIONALE
an interrupted oxygen supply.
 To provide comfort and prevent
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

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