STN Khairunnisa

Nasuha Hazizi
STN Amirah
Hanisah
Oxygen is colorless,
tasteless, and
odorless gas that is
present in the air.
Although is essential
for life.
Oxygen therapy
Principles in oxygen therapy
1. Give proper amount, lot of oxygen may be
fatal for some patients.
2. Maintain an open airway through correctly
positioning and suctioning the patient.
3. Give oral hygiene every 3-4 hours. Because
oxygen therapy drying the tissues, makes
mouth smell or taste bad.
4. Prevent infections by removing, cleaning or
replacing nasal catheter.
5. Monitor the activities of patient.
6. Do not discontinue oxygen flow immediately.
The level of blood falls drastically
as soon as oxygen turned off and may take 5-
10minutes to return to normal.
7. Observe safety measures to prevent
explosion of fire.
8. No smoking at bed side.
9. Electrical equipments should be good
working conditions.
1. Cardiac output
2. Arterial oxygen content.
3. Concentration of Hgb
4. Metabolic requirements
5. Hypoxemia (decrease in the arterial oxygen
content in the blood)
6. Hypoxia (decreased oxygen supply to the
tissues)

ABGs

Pulse oximetry


Clinical evaluation
Oxygen toxicity can occur with FLO2 > 50%
longer than 48 hours.
Suppression of ventilation will lead to
increased CO2 and carbon dioxide narcosis.
Danger of fire.
Infection
CAUTIONS FOR
OXYGEN THERAPY !!
Oxygen source
The flow meter
Humidifier
The tubing
Appropriate
appliance for the
method being used.
The Flow Meter and Humidifier
The flow meter is attached to piped-in
oxygen and regulates the amount.
The rate of flow is prescribed by physician
range from 2-12/minute.
Humidifier is attached to the flow meter
between the flow meter and tubings.
The oxygen is moisturized before entering
the air passages.
1. Pi ped i n
2. Cyl i nder
3. Oxygen
concentrator

Obtain oxygen cylinder from central service
or the respiratory therapy department.
Stand the cylinder securely to prevent from
falling.
Put cylinder beside the head of the bed
away from doors, heater etc..
Check the cylinder tag : full , in use ,
empty


1. Low flow systems :
Contribute partially
to inpired gas client
breathes
Do not provide
constant FLO2
Example : nasal
cannula,simple
mask,mask partial
rebreather & non
rebreather.

2. High flow systems
Deliver specific and
constant percent of
oxygen independent of
clients breathing.
Example : Venturi mask,
mask aerosol, face tent,
transtracheal catheter.
NASAL CANNULA
For low medium
concentration of oxygen.
Simple
Can use continuously with
meals and activity.
Flow rates in excess of 4L
cause drying and irritation.
Depth and rate of breathing
affect amount of oxygen
reaching lungs.
SIMPLE MASK
Low to medium concentration of
oxygen.
Client exhales through ports on
sides of mask.
Should not be used for controlled
oxygen levels.
Oxygen flow rate 6 to 8 L
Simple to use : inexpensive.
Can cause skin breakdown. Must
remove to eat.
Consists of mask with
exhalation ports and
reservoir bag.
Reservoir bag must remain
inflated.
O2 flow rate : 8 to 10L
Client can inhale gas from
mask, bag, exhalation
port.
Poorly fitting , must
remove to eat.
PARTIAL
REBREATHER
MASK
Similar in design to partial re-breathing mask.
Has 2 valves
1
st
valve : 1 way valve between the reservoir
bag and base of the mask.
2
nd
valve : in the exhalation port.
The one valve prevent room air from entering
the mask during inhalation.
Exhale gases to exit the mask on exhalation.
NON-REBREATHER MASK
Consists of mask, reservoir
bag, 2 one-way valves at
exhalation ports and bag.
Client can only inhale from
reservoir bag.
Bag must remain inflated at all
times.
O2 flow rate 10 to 15L
Poorly fitting ; must remove to
eat.
NON-REBREATHER MASK
Most reliable & accurate method for
delivering a precise o2 concentration.
Consist of a mask with a jet.
Excess gas leaves by exhalation ports.
O2 flow rate : 4 to 5L
Can cause skin breakdown ; must remove to
eat.
VENTURI MASK
O2 flow rate 8 to 10 L
Provides accurate FLO2
Provides good humidity ; comfortable
TRACHEOSTOMY COLLAR/MASK
Used an end of ET tube when weaning from
ventilator.
Provides accurate FLO2
Provides good humidity.
T-PIECE
Non-invasive monitoring technique that
estimates the oxygen saturation on Hgb
(SaO2)
May be used continuously or intermittently.
Must correlate values with physical
assessment findings.
Normal SaO2 values : 95% to 100%
PULSE OXIMETRY
Low
perfusion
states
Vasoconstrictor
medications
Motion
artifact
Intravascular
dye
Abnormal
Hgb
Nail polish
when using a
finger probe.
Too much
light
exposure
PROCEDURE

OXYGEN ADMINISTRATIONS OF NASAL
PRONG AND MASK

NO STEPS RATIONAL
1. Check prescription for mode,
amount and duration.
To check doctor
ordered.
2 Verify, greet and explain to
patient indication of oxygen,
procedure to patient.
To cooperation from
patient and to patient
understand.
3. Assess patient:
Skin color and nature
Respiration pattern
Level of consciosness
To detect
abnormalities.
NO STEPS RATIONAL
4. Assess oxygen supply and
oxygen set
Cylinder( check if enough
oxygen from oxygen gauge)
Wall oulet.
To recheck the
function oxygen set.
5. Prepare equipment
Fill the humidifier with distilled
water to the level specified and
close tightly.
Attach flow meter to the wall
outlet or cylinder.
Attach oxygen tubing to the
humidifier outlet.
To prepare the
equipment before
administer and to
make sure all the
equipment function
well.
NO STEPS RATIONAL
6. Test the oxygen flow
On the regulator to check
oxygen bubbles through the
distilled water in the humidifier.
Feel the oxygen flow out of the
oxygen tubing on the back of the
palm.
To the make sure
oxygen flow.
7. Clean of any oil or sweat from
patients face,nose and around
mouth.
To prevent the tubing
out from the nose.
8. Wash hand To maintain hygiene.
NO STEPS RATIONAL
9. 1.Administer oxygen through
nasal prong.
Attach nasal prongs to the
oxygen tubing and turn on to
check the oxygen flow.
Clean patients nonstrils with
cotton tip dipped in saline to
remove any dried secretion that
can obstruct oxygen flow.
Place the nasal prong into both
the patients nonstrile and under
the chin.
Anchor the nasal prong tubing
behind patients ear and under the
chin.
Slide the adjuster upward under
the chin to anchor tubing.
NO STEPS RATIONAL
2.Administer oxygen via face
mask.
Attach mask to the oxygen
tubing and turn on regulator to
check the oxygen flow.
Place mask covering mouth and
nose.
Fix mask tapes securely behind
patients head according to
patients comfort.
10. Adjust the flow meter according
to the amount ordered.
To make sure correct
amount flow meter.
11. Anchor the tube with tape by
patients bed or pillow.
To prevent the tube
no attach to patient.
NO STEPS RATIONAL
12. Instruct patient regarding risk of
fire.
Not use matches or lighter by the
bedside.
Instruct no smoking.
Place no smoking sign by
bedside for information.

To prevent fire occur .
13. Ensure patient is comfortable.
Provide face wipes regularly.
Mouth care to prevent drying of
mucous membranes.
To provide patient
comfort and prevent
dehydration.
14. Comfort the patient physically
and emotionally.
To reduce patient
anxiety.
NO STEPS RATIONAL
15. Monitor patients
Respiration pattern
Cyanosis
Anxiety or confusion
SPO2
To detect
abnormalities.
16. Document and report. To as a references.
17. Wash hand. To maintain hygien.
THANK
YOU..