Also called the nasal prongs the most common inexpensive low flow device used to administer oxygen

in consist of the rubber tube that extends around the face, with 0.6-1.3cm curved prong that fit into the nostrils.

It covers the client nose and mouth for oxygen inhalation. Most mask are made by clear, pliable plastic or rubber that can be molded to fit the face & all secured to the client head with elastic bands.

Some have metal clip that can be bent over the bridges of the nose for a snug fit. There are several holes in the side of the mask to allow the escape of inhaled carbon dioxide.

To administer oxygen to treat dyspnea by means of nasal cannula or mask. 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 of fluids.

To provide moderate oxygen support & a higher concentration of oxygen& or humidity than is provided by cannula.

Oxygen supply Humidifier with sterile, distilled water or according to agency protocol NO SMOKING sign

CANNULA: - Nasal cannula and tubing - Tape - Gauzes Face mask - Prescribed facemask fit for the patient - Padding for the elastic band

1.Determine the need for oxygen therapy, & verify the order for therapy 2.Perform hand hygiene. 3.Prepare the client & support person by: a. assisting the client to a semi fowlers position if possible. b. explaining that the o2 is not dangerous when safety precaution are observe & it will ease the discomfort for dyspnea.

4.Set up the oxygen equipment & the humidifier. a. attach the flow meter to the oxygen outlet, exerting firm pressure. Flow meter should be in the off position. b. fill the humidifier bottle with distilled/ tap water in accordance with agency protocol. c. attach the humidifier bottle to the base of the flow meter. d. attach the prescribe o2 tubing & deliver device to the humidifier.

5. Turn on the oxygen at the prescribed rate & ensure proper functioning. a. check the oxygen is flowing freely through the tubing. There should be no kinks in the tubing & connection should be airtight. b. there should be a bubbles in the humidifier as the oxygen flows through the water. You should feel the oxygen at the outlet of the cannula. c. set the oxygen at the flow rate ordered, for example 2-6 liters per minute.

Put the cannula in the clients face with the outer prongs fitting to the nares & elastic band around the head 2. If the cannula will not stay at place, tape it in the side of the face. 3. Slip gauze pads under the tubing over the cheekbones.
1.

1. 2. 3.

4.

Place the mask toward the clients face & apply it in the nose downward. Apply the mask making sure that its fits to the contour of the clients face. Secure the elastic band around the clients face so that the mask is comfortable but snug Pad the band behind the ears & over the bony prominences

6. Make the client comfortable. 7. Fill out oxygen slip taped to oxygen tank. 8. Assess the client regularly: a. assess the clients level of anxiety, color & ease of respiration, & provide support while client adjust to the cannula. b. assess the client in 15-30 min depending on the clients condition. c. assess clients for signs of hypoxia, tachycardia, confusion, dyspnea, restlessness & cyanosis.

9. Inspect the equipment on a regular basis. a. check the liter flow and the level of water in the humidifier in 30 min & whenever providing care to the client. b. maintain the level of water in the humidifier. c. make sure that safety precaution are being followed. d. in face mask inspect the facial skin frequently for dampness or chafing, & dryness & treat it as needed.

10. Document relevant date. Record the initiation of the therapy and all nursing assessment.

Respiratory compromise Cyanosis Tachypnea Hypoxemia Partially obstructed airway Respiratory failure.

Cardiac compromise Chest pain, AMI Shock Tachycardia Arrhythmias

Neurological deficits CVA Spinal injuries Coma

PROGRESSIVE HYPERCAPNIA: Seen in COPD. CIRCULATORY DEPRESSION : when hypoxia causes catecholamine surge , the only drive of cvs then correction of hypoxia may cause circulatory failure. managed by volume overload or sympathomimetic.

DRYING AND CRUSTING OF RESPIRATORY SECRETIONS. OXYGEN TOXICITY : LUNG TOXICITY Atelectasis, damage to surfactant, intralveolar edema, interstitial fibrosis and thickening. Toxic level of FIO2 is 0.6 for O2 therapy of > 48 hrs.

RETROLENTAL FIBROPLASIA : Related to high PaO2 in (>160mm of Hg for a few hours) in neonates. CEREBRAL OXYGEN TOXICITY : Observed in hyperbaric oxygen therapy. presents with fits called Paul Bert effect, after the name of 1st patient.

Normally human body tissues operate in a low oxygen environment. DISTRIBUTION OF O2 IN TISSUE : This demonstrates that human tissues normally operated in a oxygen deficient environment.

A STUDY OF 7 COPD PATIENTS WITH SEVERE HYPOXAEMIA (PaO2 <40 mm of Hg) : A STUDY OF 7 COPD PATIENTS WITH SEVERE HYPOXAEMIA (PaO2 <40 mm of Hg) Blood lactate level is a marker of tissue hypoxia (normal level < 4mmol/L )