oxygen

1. 
 Sreekanth

2. Introduction
 Oxygen is very necessary to sustain life. The cardiac and
respiratory system function collectively to meets body's
requirements of oxygen. Blood is oxygenated through the
mechanism of ventilation , perfusion, and transport of
respiratory gases
 Oxygenation ( the delivery of oxygen to the body's tissues
and cells ). Is necessity to maintain life and health clients
with compromised oxygenation status need careful
assessment and thoughtful nursing care to achieve an
adequate and comfortable level of oxygenation function

3. Definition
 Oxygenation is the process that includes both
the inspiratory and expiratory activities hence
there occurs the exchange and transport of
respiratory gases

4. Oxygen therapy
 It is the administration of oxygen as a
therapeutic modality
 Oxygen therapy benefits the patients by
increasing the supply of oxygen to the lungs and
thereby increasing the availability of oxygen to
the body tissues

5. Factors affecting oxygenation
 There are five factors affecting alteration of
oxygenation
1. Physiological factors
2. Developmental factors
3. Life style
4. Environmental factors
5. Disease process

6. Physiological factors
 Decreased oxygen carrying capacity
 Decreased inspired oxygen concentration
 Hypovolemia
 Increased metabolic rate

7. Oxygen administration
 Oxygen therapy is defined as the administration
of oxygen by inhalation from a cylinder , piped
in system liquid oxygen reservoir or oxygen
concentration by various methods to relieve
anoxemia (reduction in oxygen content of blood

8. Indication
 Breathlessness or laboured breathing
 High altitudes
 Shock & circulatory failure
 Patient under anaesthesia
 Patients who are critically ill
 Patients with a decreased respiratory capacity
 Severe respiratory distress
 Hemorrhage

9. PRECAUTIONS FOR OXYGEN
ADMINISTRATION
 Avoid naked flames near oxygen cylinder.
 Put a No Smoking sign at the entrance of the ward and
near patient bed to warn others.
 Do not use oil on the oxygen cylinder. Oil can ignite if
exposed to oxygen.
 Do not use electrical gadgets or any article which can
cause sparks near oxygen cylinder.
 Do not give oxygen to a hyperventilated patient.

10.  Keep oxygen cylinders in a dry and cool place
 Mark oxygen cylinder to indicate whether full or empty.
 Use only carriers with wheel to transport oxygen
cylinder, do not roll the oxygen cylinder.
 Oxygen must only be administered at the rate and
percentage prescribed.
 Do not adjust flow meter until instructed.
 Encourage or assist patient to move about in bed to
prevent hypostatic pneumonia or circulatory difficulties.

12. Methods of oxygen delivery
1. Nasal catheter :
 The nasal catheter is inserted into the nostrils
reaching up to the uvula & is held by adhesive tapes .
 The catheter does not interfere with the patients
freedom to eat , to talk & to move in bed
 Flow of 1 to 4 litters of oxygen will be sufficient to
maintain the concentration of 22 to 30 % oxygen

14. OXYGEN ADMINISTRATION BY
NASAL CANNULA

15. Nasal cannula :
 A nasal canula is a simple comfortable device ,
the two canula about 1.5 cm (half inch ) long ,
protrude from the centre of a disposable tube &
are inserted into the nose
 Low flow, Up to 5 litter of oxygen can provide
 through nasal canula

16. Oxygen by mask
 Oxygen mask covers the patient’s nose & mouth
 Mask is advantageous for those patients who are
unable to breathe through the nose
 Flow of 8 to 12 litters of oxygen will maintain the
concentration of 25 to 60 % of oxygen

18. Oxygen tent :
 When a patient has a facial injury or for any other reasonb
cannot tolerate an oxygen mask , then this method can be used
 Certain advantages & disadvantages for using a oxygen tent
 It provides an environment for patient with controlled oxygen
concentration , temperature regulation & humidity control
 It allows freedom for free movement in bed
 Create feeling of isolation
 It requires high volume of oxygen ( 10 to 12 liter/ minute )
 There is increased chances of fire
 It requires much time & effort to clean & maintain a tent

20. Ventuari mask
 A venturi mask is use for the patients who
require precise percentage of oxygen , such as
patient with chronic lung disease with co2
retention . A combination of valves and
specified flow rates determine oxygen
concentration

22. Care of oxygen cylinder
 Always use cylinder of metal case to prevent danger
of falling & breaking
 Oxygen cylinder should be placed at head end
 of the bed
 Any source of fire should be kept away from cylinder
for fear of fire
 Oxygen cylinder should be placed at cool
temperature

23.  When cylinder are empty , always marks i.e. “
empty “ & send for filling
 Inspect the apparatus at frequent intervals &
make sure for its good working condition
 To test any leakage in the regulator soap leather
may be used

24. Nurse’s responsibility for
administration of oxygen
 Check the name & bed no. & other identification of
patient
 Check the diagnosis & need for oxygen therapy
 Check the doctors order for the initiation of the
therapy , the dosage etc
 Check the doctors order for specific precaution
regarding the movement of the positioning of the
patient

25.  Assess the patient for any sign of clinical analysis ex:
cyanosis
 Check the patients vital sign
 Check the result of arterial blood gas analysis
 Note any signs of pulmonary dysfunction

26.  Check the patients mental state & the ability to
follow instructions
 Check the articles available in the unit
 Check the oxygen cylinder for its accessories &
their working condition

27. Procedure
 Articles
 Oxygen cylinder with stand , central supply oxygen with a flow meter ,
humidifier / connecting tubing
 A tray containing :
 Nasal catheter / O2 mask / cannula
 Water soluble lubricating jelly
 Adhesive tape
 A bowl of water
 Swab sticks & normal saline
 No smoking indication

28.  Steps of procedure
 Wash hands
 Attach canula / catheter mask to oxygen tubing &
humidified oxygen source adjusted to prescribe flow
rate
 Place tips of canula into the patients nose If masks
apply snugly to face
 Check canula / equipment every eight hours

29.  Keep the humidification jar filled at all times
 Observe the patient nose & superior surface of both ears
& skin for preventing the drying of nose
 Check the oxygen flow rate & the physician’s orders
every 8 hours
 Wash hands before removing the oxygen mask or tube
 Inspect the patient for relief of symptoms associated with
hypoxia
 Record procedure in the nurse’s record

30. After care of the patient & article
 Stay with patient
 Keep the patient warm & comfortable
 Evaluate the patients progress by observing the
vital signs
 Watch the patient for any deteriorating
 symptoms after the removal of oxygen
inhalation

31.  Requests for an arterial blood gas analysis
 Take all articles to utility room
 Clean nasal catheter with cold water , then
warm soapy water & finally with clean water .
Boil , store & send them for sterilization