1. Oxygen Administration NUR 216 Susan Liipfert Shelton RN, MSN, CNM

2. Oxygen Administration “Oxygen therapy refers to the administration of oxygen to a client to prevent or relieve hypoxia.” (Elkin et al, p.748) Hypoxia—insufficient oxygen to meet the metabolic needs of the tissues and cells Hypoxia results from Hypoxemia Deficiency of 0 2 in arterial blood

3. Oxygen Administration Assessment Complete respiratory assessment –Behavioral changes –Apprehension –Anxiety –Decreased ability to concentrate –Decreased level of consciousness (LOC) –Fatigue –Dizziness –Vital signs –Sp0 2 via pulse oximetry –Skin and mucosa coloring Arterial Blood Gas (ABG) results

4. Oxygen Administration Planning Expected Outcomes –0 2 saturation & ABGs return to or remain WNL –Client verbalizes comfort and is without symptoms of hypoxemia –“Abnormals” of respiratory assessment return to normal for client –Client is able to State indications for oxygen therapy Follow safety guidelines Use 0 2 as prescribed

5. Oxygen Administration Planning Equipment –Delivery device –Oxygen tubing –Humidifier –Sterile water –Oxygen source –Flow meter –“Oxygen in use” sign

6. Oxygen Administration Planning Nasal Cannula Venturi Mask Partial rebreathing mask Nonrebreathing mask

7. Oxygen Administration Implementation Check protocol Attach tubing & flow meter Adjust flow rate Check humidifier Observe proper fit & function Assess pulse oximetry (or ABG) Consult MD/practitioner if 0 2 level is unstable

8. Oxygen Administration Evaluation Observe repeat ABGs and/or pulse oximetry Observe behavioral response –Decreased anxiety –Improved LOC –Decreased fatigue –Absence of dizziness Assess vital signs –Decreased pulse –Decreased respiratory rate –Improved color

9. Oxygen Administration Unexpected Outcomes Nasal irritation Irritation of face Continued hypoxia Carbon dioxide retention

10. Oxygen Administration Evaluation Record & Report –Respiratory assessment findings –Method of O2 delivery, flow rate –Client’s response and any adverse reaction Documentation –0800 Client alert & oriented. Resp even and unlabored. Color pink. 02 @ 4L per NC. Productive cough of yellow sputum. Enc PO fluids. –1000 Reddened area noted behind R ear, without breakdown. Foam protector added to NC tubing. –1200 No further redness noted behind ears. Client denies discomfort from cannula.