Administering Oxygen by Nasal Catheter, Cannula or

Mask
Nasal catheter
The introduction f oxygen through the oropharynx by means
of a soft rubber tube with hole at the end.

Cannula
Also called nasal sprongs is tha most common inexpensive
low flow used to administer oxygen.
It consist of a rubber or plastic tube that extends around
the face, with 0.6 1.3 cm (1/4 1/2 inch) curved prongs
that fit into the nostrils.
 Face mask
It covers the clients nose or mouth for oxygen inhalation.
Most mask are made of clear, pliable plastic or rubber that can
be molded to fit the place and all secured to the clients head
with elastic band.
Some have metal clip that can be bent over the bridge of the
nose for a snug fit.
There are several holes in the sides of the mask (exhalation
ports) to allow the escape of exhaled carbon dioxide.
 Objectives:
To administer oxygen to treat dyspnea by means of nasal
catheter
To deliver a relatively low flow concentration of oxygen when
only minimal oxygen support is required.
To allow uninterrupted delivery of oxygen while the client
ingest food or fluids
To provide moderate oxygen support and with higher
concentration of oxygen and or humidity than is provided by a
cannula.
 Equipment:
Oxygen supply
Humidifier with sterile distilled water or according to agency
protocol NO SMOOKING sign
Additional equipment's for:
Catheter:
Nasal catheter:
Children - French no. 8-10
Adult French no. 12- 14
Flashlight
Safety pin
Plaster
 Tongue depressor

Cannula:
Nasal cannula ang tubing
Tape
Gauzes

Face mask:
Prescribes face mask fit for the patient
Padding for the elastic band
 A. LOW FLOW ADMINISTRATION DEVICES:
a. nasal catheter
b. nasal cannula 24-25% at 2-6 liters per minute
c. face mask
d. partial rebreathing mask 40-60$ at 5-8LPM
e. non rebreathing mask 60-90% at 6-10LPM
f. complete breathing mask 95-100% at 6-15 LPM
g. oxygen tent
Commonly used for children
Consist of rectangular, clear plastic canopy with outlets that
connects to an oxygen or compressed air source and to a
humidifier that moisturizes the air or oxygen
 B. HIGH FLOW ADMINISTRATION DEVICES:
a. Venturi mask
Low concentration ostomy
A type of mask that s preferably used for COPD clients because
it provides accurate amount of oxygen requirement that is 2-3
LPM or 28% oxygen
b. face mask
c. oxygen hood
Used for low or high flow concentration
It is a rigid dome that encloses the infants head
Provide oxygen level and high humidity
 The gas should not be allowed to flow directly into the infants face
and the hood should not rub against the infants neck, chin or
shoulder
d. incubator/isolettte
Used for low and high flow concentration
 Steps Rationale
Determine the need for Respiratory assessment is done
oxygen therapy and verify the to determine the needed for
order for therapy oxygen therapy and to develop
baseline data if not already
available. Oxygen maybe
administered without doctors
order in cases of emergency

Prepare the client and

support person by:
a. assisting the client to a
semi fowlers position if
possible
 b. explaining that oxygen is not
dangerous when safety precautions
are observed and it will ease the
discomfort of dyspnea
The position permits easier chest
expansion and hence easier
breathing. Inform the client and
support persons about the safety
precautions connected with oxygen
use
Hang a NO SMOOKING sign outside
the single room. If in the ward,
hang in a place easily seen by all
Check electrical appliances before
use. Small sparks may cause a fire if
there is leakage of oxygen
Avoid use of oil, greases, alcohol
and either near the client with
oxygen this further support
combustion
 Set up the oxygen equipment and The humidifier is filled with
the humidifier distilled water up to the level
Attach the flow meter to the mark. If theres no level mark, fill
oxygen outlet, exerting firm humidifier half full
pressure. The flow meter
should be in off position
Fill the humidifier bottle with
distilled/tap water in
accordance with agency
protocol(this can be done
before coming to bedside)
Attach the humidifier bottle
to the base of flow meter
Attach the prescribed oxygen
tubing and delivery device to
the humidifier
 Turn on the oxygen at the
prescribed rate, and ensure
proper functioning.
Check the oxygen is flowing This could be done by placing
freely through the tubing. the catheter near your face or
There should be no kinks in on the dorsum of the hand to
the tubing and connections check flow of oxygen
should be airtight. There
should be bubbles in the
humidifier as the oxygen
flows through the water. You
should feel the oxygen at the
outlets of the cannula.
Set the oxygen at the flow Excessive administration of
rate ordered, for example 2- oxygen can cause oxygen
6 LPM narcosis(resp. alkalosis)
 Apply the appropriate oxygen
delivery device
a. nasal catheter
Measure the length of catheter
to be inserted by holding it
horizontally from the tip of the
nose to the earlobe
Moisten the tip of the catheter
with water to facilitate easy
passage of the catheter
Elevate the tip of the nose
gently until the mark on the
catheter is reached
Check if the catheter is in the
The catheter should behind the
right position by depressing the
uvula
tongue. Use the flashlight for
better visualization
 Fasten the catheter to the side Pin the connecting tube on the
of the patients face and drape pillow case or back of the mattress.
it over his ear. Some models have a strap to adjust
under the chin.
b. nasal cannula
Put the cannula over the
clients face, with the outlet
prongs fitting into the nares
and the elastic band around the
head
If the cannula will not stay in
place, tape it at the side of the
face
Slip gauze pads under the To prevent skin irritation
tubing over the cheekbones
 c. face mask
Place the mask toward the
clients face and apply it from
the nose downward
Apply the mask making sure The mask should mold to the face,
that it fits to the contour of the so that very little oxygen escapes
clients face into the eyes or around the cheeks

Secure the elastic band around

the clients head so that the
mask is comfortable but snug
Pad the band behind the ear
and over the bony prominences
 Make the client comfortable
Fill out oxygen slip taped to oxygen
tank

Assess the client regularly

Assess the clients level of
anxiety, color and ease of
respiration and provide support
while the client adjust to the
cannula
Assess the client in 15-30 Assess vital signs, color, breathing
minutes depending on the pattern and chest movements
clients condition and regularly
thereafter
 Assess the client regularly for Obtain arterial blood gas results if
signs of hypoxia, tachycardia, they are available
confusion, dyspnea, restlessness
and cyanosis
Nasal catheter
Assess the clients nares for Change catheter every 8 hours as
encrustations and irritation. necessary. Water soothes the mucous
Apply a water soluble lubricant as membrane
required
Face mask
Inspect the facial skin frequently
for dampness or chafing, and
dryness and treat it as needed
 Inspect the equipment on a regular
basis
Check the liter flow and the
level of water in the humidifier
in 30 minutes and whenever
providing care to the client
Maintain the level of water in Empty humidifier, rinse, and fill with
the humidifier distilled or tap water every 24 hours

Make sure that safety

precautions are being followed.

Document relevant data: record the

initiation of the therapy and all
nursing assessment
 EVALUATION FOCUS Hypoxia insufficient oxygenation
Vital signs: signs od hypoxia, of the tissues
hypercarbia, bilateral lung sounds, Eupnea normal
blood gas level, color of skin, nails, breathing/effortless, noiseless
lips, and earlobes, activity breathing
intolerance: level of anxiety
 NEBULIZATION
It is used to deliver fine spray (fog or mist) of medications or
moisture to a client

Objectives:
To know how to administer the medication through inhalation
safety and effectively
To help loosen the secretions

Equipments:
Metered dose inhaler (MDI) hand haler nebulizer
 A pressurized container of medication that can be used by the
client to release the medication through a nose piece or
mouthpiece.
Spacers
Areholding chambers into which the medication is fired and from
which the client inhales, so that the dose is not lost by
exhalations.

TWO KINDS OF NEBULIZATION:

1. atomization
A device that produces large droplets for inhalation
 2. aerosolization
The droplets are suspended in a gas such as oxygen
The smaller the droplets, the further they can be inhaled into the respiratory
tract
When a medication is intended for the nasal mucusa. It is inhaled through the
nose
When it is intended for the trachea, bronchi or lungs. It is inhaled through the
mouth
 Steps rationale
Assemble equipment at bedside
Introduce yourself and identify the
client
Explain the procedure and what
you are going to do
Make sure the canister is firmly
and fully inserted into the inhaler
Remove the mouthpiece cap and
holding the inhaler cap right,
shake the inhaler vigorously for 3-
5 sec to mix the medicine evenly
Exhale comfortably (as in normal
breath)
 Hold the canister upside down
Hold MDI to 2-4 cm(1-2 in) from
the open mouth
Put mouthpiece far enough into
the mouth with opening toward
the throat
Close lips tightly around
mouthpiece
Administer medication
Press down once on the MDI canister Pressing down the MDI canister
and inhale slowly and deeply release the dose
through the mouthpiece

Hold breath for 10 seconds Allows the aerosol to reach deeper

airways
 Remove inhaler away from the MDI contains steroids for an anti-
mouth inflammatory effect. Prolonged use
increases the risk of fungal
infections in the mouth

Exhale slowly through purse lips Controlled exhalation keeps the

small airways open during
exhalation

Repeat inhalation if ordered Wait 20 30 seconds between

inhalations of bronchodilator
medication to give chance to work
and subsequent dose reaches
deeper into the lungs
 After inhalation, rinse mouth with tap water to remove
remaining medications and decrease irritations and risk of
infection
Clean MDI after each use with soap and water and rinse
Store canister at room temperature. Avoid extremes of temp
Document time a type of medication. Note patients respone