1. health and fitness
2. therapy

Oxygen therapy
OUT LINE
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Definition of the oxygen therapy
Types of oxygen therapy
purposes of using the oxygen
therapy
Administration of oxygen therapy
Complication of oxygen therapy
LEARNING OBJECTIVES:
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Define the oxygen therapy
Discuss the type of c oxygen
therapy
List the purpose of using the
oxygen therapy
Explain the procedure
Demonstrate the procedure
List Complication of oxygen
therapy
OXYGEN THERAPY
Definition:
 Oxygen is a colorless, odorless,
tasteless gas that is essential for the
body to function properly and to
survive.
WHAT IS MEANING OF O2 THERAPY
 Oxygen
therapy is the administration
of oxygen at a concentration of
pressure greater than that found in
the environmental atmosphere
 The air that we breathe contain
approximately 21% oxygen
 the heart relies on oxygen to pump
blood.
WHAT IS MEANING OF O2 THERAPY
 If
not enough oxygen is circulating in
the blood, it’s difficult for the tissues
of the heart to keep pumping.
 Supplemental
oxygen is used to treat
medical conditions in which the
tissues of the body do not have
enough oxygen.
PURPOSE
The
body is constantly taking
in oxygen and releasing carbon
dioxide.
 If this process is inadequate,
oxygen levels in the blood
decrease, and the patient may
need supplemental oxygen.
PURPOSE
Oxygen
therapy is a key
treatment in respiratory care.
The
purpose is to increase
oxygen saturation in tissues
where the saturation levels are
too low due to illness or injury.
OXYGEN THERAPY IS USED TO TREAT
 Example
in case : Documented hypoxemia
 Severe respiratory distress (acute
asthma or pneumonia)
 Severe trauma
 Chronic obstructive pulmonary
disease (COPD, including chronic
bronchitis, emphysema, and chronic
asthma)
OXYGEN THERAPY IS USED TO TREAT
 Pulmonary
hypertension
 Acute myocardial infarction (heart
attack)
 Short-term therapy, such as postanesthesia recovery
 Oxygen may also be used to treat
chronic lung disease patients during
exercise .
METHODS OF DISPENSING OXYGEN
Piped
in
Cylinder
Oxygen
concentrator
SOURCES OF OXYGEN:
Cylinder.
2- Wall outlets.
 1-
 Oxygen
is moistened by passing it
through a humidification system to
prevent the mucous membranes of
the respiratory tree from becoming
dry.
1-
USING OXYGEN CYLINDERS:
 The
oxygen cylinder is delivered with
a protective cap to prevent accidental
force against the cylinder outlet.
 To
release oxygen safety and at a
desirable rate, a regulator is used. It
consists of two parts.
USING OXYGEN CYLINDERS:
 A reduction gauge that reduces the
pressure to a working level and shows
the amount of oxygen in the tank.
a flow meter that regulates the
control of oxygen in liters per minutes.
2- WALL – OUTLET OXYGEN:
 The
oxygen is supplied from a
central source through a pipeline.

Only a flow meter and a humidifier
are required.
PREPARATION
A
physician's order is required for
oxygen therapy, except in emergency
use.
 Clinical observations.
 Oxygen supplemental is determined
by inadequate oxygen saturation.
 indicated in Artial Blood Gas
measurements,(ABGs ) .
 Pulse Oximetry.
CAUTIONS FOR OXYGEN THERAPY
 Oxygen
toxicity – can
occur with FIO2 > 50%
longer than 48 hrs
 Suppression of
ventilation – will lead
to increased CO2 and
carbon dioxide
narcosis
 Danger of fire
 Infection
Methods
of oxygen
administration:
CLASSIFICATION OF OXYGEN
DELIVERY SYSTEMS
 Low
flow systems
 contribute partially to inspired gas client
breathes
 do not provide constant FIO2
 Ex: nasal cannula, simple mask , non-re
breather mask , Partial rebreather mask
 High flow systems
 deliver specific and constant percent of
oxygen independent of client’s breathing
 Ex: Venturi mask,, trach collar, T-piece
METHODS OF OXYGEN ADMINISTRATION:
1- Nasal cannula 
NASAL CANNULA (PRONGS):
It is a disposable.
 plastic devise with two protruding
prongs for insertion into the nostrils,
connected to an oxygen source.

 Used
for low-medium concentrations
of Oxygen (24-44%).
Method
Nasal
Cannula
Amount
Delivered
F1o2
(Fraction
Inspired
Oxygen)
Priority
Nursing
Interventions
Check
frequently
Low flow
that both
24-44 %
prongs are in
1 L\min=24% clients nares
2 L\min=28%
3 L\min=32% Never
4 L\min=36% deliver more
5 L\min=40% than 2-3 L\min
6 L\min=44% to client with
chronic lung
disease
Advantages
 Client able
to talk and
eat with
oxygen in
place
Disadvantages
may cause
irritation to
the nasal
and
pharyngeal
mucosa
Easily used
if oxygen
in home
flow rates
setting
are above 6
liters/minute
Variable
FIO2
FACE MASK
 The
simple Oxygen mask
 The partial rebreather mask:
 The non rebreather mask:
 The venturi mask:
THE SIMPLE OXYGEN MASK
Simple mask is made of
clear, flexible , plastic
or rubber that can be
molded to fit the face.
 It is held to the head
with elastic bands.
 Some have a metal clip
that can be bent over
the bridge of the nose
for a comfortable fit.

THE
 It
SIMPLE
OXYGEN
MASK
delivers 35% to 60% oxygen .
 A flow rate of 6 to 10 liters per minute.
 It has vents on its sides which allow
room air to leak in at many places,
thereby diluting the source oxygen.
 Often it is used when an increased
delivery of oxygen is needed for short
periods
 (i.e., less than 12 hours).
Method
Amount
Delivered
F1o2
(Fraction
Inspired
Oxygen)
Simple mask
Low Flow
6-10 L\min
35%-60%
Priority Nursing
Interventions
Monitor client
frequently to
check
placement of
the mask.
Support client
if
claustrophobia
is concern
Secure
physician's
order to replace
mask with nasal
cannula during
meal time
Advantages
Can
provide
increased
delivery of
oxygen for
short
period of
time
Disadvantages
Tight seal required
to deliver higher
concentration
Difficult to keep
mask in position
over nose and mouth
Potential for skin
breakdown (pressure,
moisture)
Wasting
Uncomfortable for
pt while eating or
talking
Expensive with
nasal tube
THE PARTIAL REBREATHER MASK:
The mask is have with a reservoir bag must
romaine inflated during both inspiration &
expiration
 It collection of the first parts of the
patients' exhaled air.
 It is used to deliver oxygen concentrations
up to 80%.

THE PARTIAL REBREATHER MASK
The oxygen flow rate
must be maintained at a
minimum of 6 L/min to
ensure that the patient
does not rebreathe
large amounts of
exhaled air.
 The remaining exhaled
air exits through vents.

THE NON REBREATHER MASK

This mask provides the
highest concentration of
 oxygen (95-100%) at a flow
rate6-15 L/min.
 It is similar to the partial
rebreather mask
 except two one-way valves
prevent conservation of
exhaled air.
 The bag is an oxygen
reservoir
THE NON REBREATHER MASK
When the patient exhales
air.
 the one-way valve closes
and all of the expired air
is deposited into the
 atmosphere, not the
reservoir bag.
 In this way, the patient is
not rebreathing any of
the expired gas.

Method
Amount
Delivered
F1o2 (Fraction
Inspired
Oxygen)
Priority
Nursing
Interventions
Partial Rebreather Mask
Low Flow Set flow
rate so
6 L\min
mask
remains
75%-80% tow-thirds
oxygen
full during
inspiration
Keep
reservoir
bag free of
twists or
kinks
Advantages
Disadvantages
Clinet
can inhale
room air
through
openings
in mask if
oxygens
supply is
briefly
interrupted
Requires
tight seal
(eating and
talking
difficult,
uncomfort
able
Not as
drying to
mucous
membrane
s
Method
Amount
Delivere
d
F1o2
Priority Nursing
Interventions
Non
rebreather MASK
Maintain flow
rate so
reservoir bag
collapses only
slightly during
inspiration
80%100% Check that
valves and
rubber flaps
are function
properly (open
during
expiration )
Monitor SaO2
with pulse
oximeter
Low
Flow
6-15 L
\min
Advantages
Disadvantages
Delivers the
highest
possible
oxygen
concentratio
n
Suitable for
pt breathing
spontaneous
with sever
hypoxemia
Impractical
for long term
Therapy
Malfunction
can cause CO2
buildup
suffocation
Expensive
Feeling of
suffocation
Uncomfortabl
e
Costly
VENTURI MASK
It is high flow
concentration of oxygen.
 Oxygen from 40 - 50%
 At liters flow of 4 to 15
L/min.
 The mask is so
constructed that there is
a constant flow of room
air blended with a fixed
concentration of oxygen

THE VENTURI MASK
 is
designed with wide- bore tubing and various
color - coded jet adapters.
 Each color code corresponds to a precise
 oxygen concentration and a specific liter flow.
The venturi system,
 Room
air dilutes the oxygen entering the
tubing to a certain concentration
 The amount of air drawn in is determined by
the size of the orifice (jet adapter).
THE VENTURI MASK
The narrower the jet adapter,
 the greater the air dilution, and the
lower the concentration of oxygen.
 It
is used primarily for patients with
chronic obstructive pulmonary disease
Method
Amount
Delivered
F1o2
Venturi Mask
Priority
Nursing
Interventio
ns
Advantage
s
Disadvantages
Requires
careful
mointoring
to verify
of 4 to 15 F1O2 at
flow rate
L/min.
ordered
Check
that air
intake
valves are
not
blocked
Delivers
most
precise
oxygen
concentrati
on
Doesn’t
dry
mucous
membrane
s (humidity
uncomfortable
Risk for skin
irritation
produce
respiratory
depression in
COPD patient
with high
oxygen
concentration
50%
Oxygen
from 40-50%
TRACHEOSTOMY COLLAR/ MASK
 Inserted
directed into trachea
 Is indicated for chronic o2
therapy need
 O2 flow rate 8 to 10L
 Provides accurate FIO2
 Provides good humidity.
 Comfortable ,more efficient
 Less expensive
T-PIECE
 Used
on end of
ET tube when
weaning from
ventilator
 Provides
accurate FIO2
 Provides good
humidity
SIDE EFFECT & COMPLICATION OF
OXYGEN THERAPY
 Oxygen
toxicity
 Retrolental fibroplasia
 Absorption atelectasis
OXYGEN TOXICITY
It is a condition in which ventilator
failure
 occurs due to inspiration of a high
concentration of oxygen for aprolonged
period of time.
 Oxygen
concentration greater than
50% over 24 to 48 hours can cause
pathological changes in the lungs.
Signs and symptoms of oxygen toxicity:
• Non-productive cough.
• Nausea and vomiting.
• Substernal chest pain.
• Fatigue.
• Nasal stuffiness.
• Headache.
• Sore throat.
• Hypoventilation.
. Nasal congestion.
. Dyspnea.
. Inspiration pain.
SIDE EFFECT & COMPLICATION OF
OXYGEN THERAPY
 Retrolental
fibroplasia
Blindness due to vasoconstriction &
ischemia ( premature infants )
SIDE EFFECT & COMPLICATION
OF OXYGEN THERAPY
 Absorption
atelectasis
 100
% FLO2 breathing associated with
decrease ventilation ( obstruction )
 Hypoventilation
( increase 30 /M )
Effect ( lung collapse )
Technique of oxygen administration
A-Administering oxygen by nasal cannula:
Steps
Rational
•Assessment:





Check the physician order.
Assesses physical condition
Assess vital signs ,
Assess level of consciousness
Assess the laboratory results,
especially the ABG analyses,
 Assess risk of CO2retention
with oxygen administration
provide a baseline data for
future assessment
Oxygen maybe depress the
hypoxia drive ( decrease
respiratory rate , alliterate
mental states
*If Paco2 is decrease or normal
( PT not expression CO2
retention & can use oxygen
without fear
ASSESSMENT

. Identify
the type of oxygen equipment and
oxygen source in your facility
Steps
Rational
*Planning:
Wash hands.
To prevent
Prepare equipment
infection.
Oxygen therapy
plastic nasal cannula
connection tube,
Simple face mask
The partial rebreather mask
The non rebreather mask
The venturi mask
Steps
Rational
Humidifier filled with
distilled water .
Flow meter
No smoking signs
Humidification
maybe not be ordered if
the flow rate is <4
/l/min
Steps
Rational
*Implementation:
Identify the patient.
To be sure you are
performing the procedure
for the correct patient.
To gain his cooperation.
Explain procedure to the
patient.
Assist the patient to a semi- This position permits
fowler's position if possible. easier chest expansion and
hence easier breathing.
Attach the oxygen supply
To prevent dehydration of
tube with humidification to
mucous membrane.
the cannula , face mask.
Steps
Rational
Allow 3-5 L oxygen to flow
through the tubing.
Low flow
Place the prongs in the
patient's nostrils and adjust it
comfortably.
To facilitate oxygen
administration and comfort
the patient.
Use gauze pads both behind
the head or the ears and under
the chin and tighten to comfort.
1 L\min=24%
2 L\min=28%
3 L\min=32%
4 L\min=36%
5 L\min=40%
6 L\min=44%
To reduce irritation and
pressure and protect the skin.
Steps
Rational
Adjust the flow rate to the
ordered level.
To provide optimal
delivery of oxygen to
patient..
Encourage patient to breath
through his nose with his mouth
closed.
Assess the patient nose and
Oxygen dries the mucous
mouth and provide oronasal care membrane and cause
at least every 8 hours.
irritation
Steps
Rational
face mask
Ensure pt
Produce the flow rate ( 10
receive flow
-12 l/min )
sufficient
to
meet
Attach the oxygen supply tube
aspiratory
to the mask .
demand
&
Regulate the oxygen flow.
maintain
Position the mask over the
accurate
patient's nose and mouth.
concentration
And fit it securely, shaping the
oxygen
metal band on the mask to the
bridge of the nose.
Steps
 Adjust the elastic band
around the patient's head and
tighten.
Rational
To ensure a
tight fit.
Use gauze pads both behind
the head or the ears.
To reduce
irritation and
pressure and
protect the skin.
Adjust the flow rate to the
ordered level.
Steps
Rational
Remove the mask
There is danger of
and dry the skin every inhaling powder if it is
2-3 hours if the oxygen placed on the mask.
is running
continuously.
 Don't powder
around the mask.
Wash your hands.
Steps
The partial rebreather mask
The non rebreather mask
The venturi mask
Attach tubing to flow meter
 Show the mask to pt & explain
procedure
 Turn on oxygen flowmeter &
prescribed rate ( usually
indicated on mask )
 Place mask over pt nose &
mouth under chin
Rational
to ensure
correct air
/ oxygen
mix
EVALUATION:
 Breathing
pattern regular and at
normal rate.
 pink color in nail beds, lips,
conjunctiva of eyes.
 No confusion, disorientation,
difficulty with cognition.
 Arterial oxygen concentration or
hemoglobin
 Oxygen saturation within normal
limits.
DOCUMENTATION:
Date
and time oxygen started.
Method of delivery.
Oxygen concentration and flow rate.
Patient observation.
Add oronasal care to the nursing care
plan
O2 DELIVERY DEVICES CONT.
EQUIPMENT
FLOW
FIO2
12 -15 L/M
1.0
ANESTHESIA
BAG
*** SHOWS THAT FIO2 VARIES WITH DIFFERENT
F, VT, INSPIRATORY FLOW RATES.
SPECIAL NOTES
USE AT 12 L/M MIN.
POTENTIAL OF
BAROTRAUMA
OR ASPHYXIATION
O2 DELIVERY DEVICES CONT.
EQUIPMENT
FLOW
FIO2
.24 - 44***
SPECIAL NOTES
NASAL CANNULA
1/2 - 6 L/M
SIMPLE O2 MASK
(WITHOUT BAG)
6 - 10 L/M
.35 - 55***
USE 5 L/M
MINIMUM
RESERVOIR MASK
(MASK WITH BAG)
10-15 L/M
.60 -80***
VENTI MASK
3 L/M
6 L/M
.24, 26, 31,
.35, .40, .50
PAGE RT IF USED
(BAG TO NOT
COLLAPSE)
READ ENCLOSED
INSTRUCTIONS
NEBULIZER
8 L/M OR >
.28, .30, .35
.40, .50, 70
1.0***
1.0
12 -15 L/M
ANESTHESIA
BAG
*** SHOWS THAT FIO2 VARIES WITH DIFFERENT
F, VT, INSPIRATORY FLOW RATES.
6 L/M MAX.
MIST MUST BE
VISIBLE
USE AT 12 L/M MIN.
POTENTIAL OF
BAROTRAUMA
OR ASPHYXIATION