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ADMINISTERING OXYGEN BY CANNULA, FACE MASK OR FACE TENT

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quenie concepcion

on 29 August 2013

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Transcript of ADMINISTERING OXYGEN BY CANNULA, FACE MASK OR FACE TENT

ADMINISTERING OXYGEN BY CANNULA, FACE MASK OR FACE TENT
PURPOSES:
Ø CANNULA
 To deliver a relatively low concentration of oxygen when only minimal O2 support is required
 To allow uninterrupted delivery of oxygen while the client ingest food or fluids
Ø FACE MASK
 To provide moderate O2 support and a higher concentration of oxygen and/or humidity than is provided by cannula
Ø FACE TENT
 To provide high humidity
 To provide oxygen when a mask is poorly tolerated
 To provide a high flow of O2 when attached to a Venturi system
ASSESSMENT
ASSESS:
 Breathing patterns.
 Skin and mucous membrane color.
 Chest movements.
 Chest wall configuration.
Lung sounds audible by auscultating the chest and by ear.
 Presence of clinical signs of hypoxemia: tachycardia, tachypnea, restlessness, dyspnea, cyanosis, and confusion.
 Presence of clinical signs of hypercarbia (hypercapnia): restlessness, hypertension, headache, lethargy and tremor.
 Presence of clinical signs of oxygen toxicity: tracheal irritation and cough, dyspnea, and decreased pulmonary ventilation.
PLANNING
Consult with a respiratory therapist as needed in the beginning and during ongoing care of clients receiving ordered oxygen therapy. In many agencies, the therapist establishes the initial equipment and client teaching.
EQUIPMENT
Ø CANNULA
 Oxygen supply with a flow meter and adapter.
 Humidifier with distilled water or tap water according to agency protocol.
 Nasal cannula and tubing
 Tape
 Padding for the elastic band
Ø FACE MASK
 Oxygen supply with a flow meter and adapter
 Humidifier with distilled water or tap water according to agency protocol
 Prescribed face mask of appropriate size
 Padding for the elastic band
Ø FACE TENT
 Oxygen supply with a flow meter and adapter
 Humidifier with distilled water or tap water according to agency protocol
 Face tent of appropriate size
IMPLEMENTATION
Ø PREPARATION
1. Determination the need for oxygen therapy, and verify the order for the therapy.
• Perform a respiratory assessment to develop baseline data if not already available.
2. Prepare the client and support people.
• Assist client to a semi-Fowler’s position if possible.
Rationale: This position permits easier chest expansion and hence easier breathing.
• Explain that oxygen is not dangerous when safety precautions connected with oxygen use.

Ø PERFORMANCE
1. Prior to performing the procedure, introduce self and verify the client’s identity using agency protocol. Explain to the client what you are going to do, why it is necessary, and how he or she can cooperate. Discuss how effects of the oxygen therapy will be used in planning further care or treatments.
2. Perform hand hygiene and observe appropriate infection control procedures.
3. Provide for client privacy, if appropriate.
4. Set up the oxygen equipment and the humidifier.
• Attach the flow meter to the wall outlet or tank. The flow meter should be in the off position.
• If needed, fill the humidifier bottle
• Attach humidifier bottle to the base of flow meter.
• Attach the prescribed oxygen tubing and delivery device to the humidifier.
5. Turn on the oxygen at the prescribed rate and ensure proper functioning.
• Check that the oxygen is flowing freely through the tubing. There should be no kinks in the tubing and the connections should be airtight. There should be bubbles in the humidifier as the oxygen flows through. You should feel the oxygen at the outlets of the cannula, mask or tent.
• Set the oxygen at the flow rate ordered.

6. Apply the appropriate oxygen delivery device.
CANNULA
• Put the cannula over the client’s face, with the outlet prongs fitting into nares and the elastic band around the head. Some models have a strap to adjust under the chin.
• If cannula will not stay in place, tape it at the sides of the face.
• pad the tubing and band over the ears and the cheekbones as needed.
FACE MASK
• Guide the mask towards the client’s face, and apply it from the nose downward.
• Fit the mask to the contours of the client’s face.
Rationale: The mask should mold to the face, so that very little oxygen escapes into the eyes or around the cheeks and chin.
• Secure the elastic band around the client’s head so that the mask is comfortable but snug.
• Pad the band behind the ears and over bony prominences.
Rationale: Padding will prevent irritation from the mask.
FACE TENT
• Place the tent over the client’s face and secure the ties around the head.
7. Assess the client regularly.
• Assess client’s vital signs, level of anxiety, color and ease of respiration and provide support while the client adjusts to the device.
• Assess the client regularly for clinical signs of hypoxia, tachycardia, confusion, dyspnea, restlessness and cyanosis. Review oxygen saturation or arterial blood gas results if they are available.
NASAL CANNULA
• Assess the client’s nares for encrustations and irritation. Apply a water soluble lubricant as required to soothe the mucous membranes.
• Assess the top of the client’s ears for any signs of irritation from the cannula strap. If present, padding with a gauze pad may help relieve discomfort.
FACE MASK OR TENT
• Inspect the facial skin frequently for dampness or chafing and dry and treat it as needed.
8. 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.
• Be sure that water is not collecting in dependent loops of the tubing.
• Make sure that safety precautions are being followed.
9. Document findings in the client record using forms or checklist supplemented by narrative notes when appropriate.

EVALUATION
 Perform follow-up based on the findings that deviated from expected or normal for the client. Relate findings to previous data if available.
 Report significant deviations from normal to the primary care provider.

Erb, G & Kozier, B. (2008). Fundamentals in Nursing 8th Edition Volume 2. Philippines: Pearson Education South Asia PTE. LTD.
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