Oxygen Therapy

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OXYGENATION

• PREPARED BY JESSICA M. SALDANA

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OXYGEN THERAPY

• Administration of oxygen at greater than 21
  (the concentration of oxygen in room air) to
  provide adequate transport of oxygen in the
  blood, to decrease the work of 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 oxygen therapy to
  prevent hypoxia.

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Oxygen Delivery System

• Nasal Cannula

• It delivers a relatively low concentration of
  oxygen (24 -45 ) at flow rate of 2 6 L/min.

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Oxygen Delivery System

• Simple Face Mask

• It delivers oxygen concentrations from 40 - 60
  at liter flows of 5 - 8 L/min

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Oxygen Delivery System

• Partial Rebreather Mask

• Delivers oxygen concentrations of 60 - 90 at
  liter flows of 6 10 L/min.
• The oxygen reservoir bag that is attached allows
  the client to re-breathe about the first third
  of the exhaled air in conjunction with oxygen.

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Oxygen Delivery System

• Non- Rebreather Mask

• Delivers the highest oxygen concentration
  possible 95 -
• 100 at liter flows of 10 15 L/min.
• One way valves on the mask and between the
  reservoir bag
• and the mask prevent the room air and the
  clients exhaled air
• from entering the bag so only the oxygen in the
  bag is inspired.

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Oxygen Delivery System

• 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

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Oxygen Delivery System

• Color codes

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Oxygen Delivery System

• Face Tent

• Can replace oxygen mask when mask is poorly
  tolerated by
• clients
• Face tents provide varying concentrations of
  oxygen.

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Oxygen Delivery System

• NOTE
• Clients using face mask and face tent, frequently
  check and inspect the clients facial skin for
  dampness or chafing and dry and treat as needed.

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Oxygen Delivery System

• Transtracheal Oxygen Delivery

• May be used for oxygen dependent client.
• Oxygen is delivered through a small, narrow
  plastic cannula
• surgically inserted directly into the trachea.
• Clients require less oxygen .5 2 L/min, because
  all of the
• flow delivered enters the lungs

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Oxygen Therapy Safety Precaution

• Place cautionary signs reading No SMOKING
  Oxygen in Use on the clients door at the foot
  or head of the bed and onthe oxygen equipment
• Note
• Oxygen is colorless, odorless, tasteless and a
  dry gas that support combustion, therefore
  leakage cannot be detected.

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Oxygen Therapy Safety Precaution

• 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
• Instruct the client and visitors about the hazard
  of
• smoking with oxygen in use.

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Oxygen Therapy Safety Precaution

• Make sure that electric device are in good
  condition in order to prevent the occurrence of
  short-circuit sparks.
• Make known the location of fire extinguishers

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EQUIPMENT

• Flow Meter with Humidifier

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EQUIPMENT

• Flow Meter and Adapter

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EQUIPMENT

• Oxygen Humidifier attached to a wall-outlet
  oxygen flow

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Administering Oxygen by Cannula, Face Mask or
Face Tent

• 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.

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Administering Oxygen by Cannula, Face Mask or
Face Tent

• PURPOSES

• Face Mask
• To provide moderate O2 support and a higher
  concentration of oxygen or
• humidity than is provided by cannula.

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Administering Oxygen by Cannula, Face Mask or
Face Tent

• PURPOSES

• Face Tent
• To provide high humidity
• To provide O2 when a mask is poorly tolerated.
• To provide a high flow of 02 when attached to a
  Venturi system.

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Equipment

• Cannula
• Oxygen supply with a flow meter and adapter
• Humidifier with distilled/sterile water
• Nasal Cannula and Tubing

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Equipment

• 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

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Equipment

• Face Tent
• Oxygen supply with a flow meter and adapter
• Humidifier with distilled/sterile water
• Face tent of the appropriate size

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Assessment

• Assess
• Skin and Mucous membrane color Note whether
  cyanosis is present.
• Breathing Pattern Alteration
• Rate
• Tachypnea Rapid RR
• Bradypnea Slow RR
• Apnea Cessation of breathing
• Volume
• Hyperventilation - Excessive amount of inspired
  air in the lungs.
• - Deep rapid respirations.
• Hypoventilation - Dec. rate/ depth of resp.
• - Excessive CO2 retention

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Assessment

• Rhythm
• Cheyne-stokes marked rhythmic waxing and
  waning of respiration
• from very deep to very shallow
  breathing and
• 
  temporary apnea.
• Kussmauls Increased rate and depth of
  breathing to remove
• 
  excess CO2 in the lungs.
• Apneustic Prolong gasping inspiration
  followed by a very
• 
  short, usually inefficient expiration.
• Biots Shallow breaths interrupted by apnea

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Assessment

• Ease of Effort
• Dyspnea Difficulty or labored
• breathing
• Orthopnea Inability to breath except in
• upright or
  sitting

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Assessment

• Chest movement
• Lung sound
• Sign of Hypoxemia
• tachycardia ( early sign )
• Tachypnea
• Restlessness
• Dyspnea
• Cyanosis
• confusion ( late sign )

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ASSESSMENT

• Sign of Hypercapnia (Excess CO2)
• restlessness
• HPN
• Headache
• lethargy
• tremor
• Sign of Oxygen Toxicity
• tracheal irritation
• substernal discomfort
• Cough
• Dyspnea
• Paresthesia
• dec. pulmonary ventilation

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Steps / Procedure Rationale

• ACTION

• RATIONALE

• Determine the need for
• oxygen therapy and verify
• doctors order.
• Identify and inform the client and explain the
• procedure.
• Assist the client to a semi fowlers position if
  possible.

• To allay anxiety
• Permits easier chest expansion and breathing

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Steps / Procedure Rationale

• ACTION

• RATIONALE

• Wash hands and observe
• appropriate infection control
• Set up the oxygen equipment and the humidifier
  filled with
• distilled/sterile water
• Attach the flow meter to the
• wall or tank. The flow meter
• should be in the off position.
• Attach the humidifier bottle to
• the base of the flow meter
• Attach the O2 tubing

• To minimize spread of infection from patient to
  patient.
• To prevent air leakage

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Steps / Procedure Rationale

• ACTION

• RATIONALE

• Turn on the oxygen at the
• prescribed rate and ensure
• Proper functioning
• Apply the appropriate
• devices
• CANNULA
• Put over the clients face, with the outlet
  prongs fitting into the nares.

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Steps / Procedure Rationale

• ACTION

• RATIONALE

• FACE MASK
• Fit the mask to the contours of the
• clients face,
• apply it from the
• nose downward
• FACE TENT
• Place the tent over the clients face

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Steps / Procedure Rationale

• ACTION

• RATIONALE

• Assess client regularly
• NOTE
• Client using cannula, check the nares for
  irritation, apply water solublelubricant as
  needed
• Inspect equipment regularly
• Document relevant information

• Clients using face mask and face tent, frequently
  check and inspect the clients facial skin for
  dampness or chafing and dry and treat as needed.

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• To prevent air leakage
• Turn on the oxygen at the
• prescribed rate and ensure
• proper functioning
• Apply the appropriate
• devices
• Ø CANNULA
• - Put over the clients face, with
• the outlet prongs fitting into the
• nares.
• Ø FACE MASK
• - Fit the mask to the contours of
• the clients face, apply it from
• the nose downward
• Ø FACE TENT