A patient will need oxygen therapy when hypoxemia results from a respiratory or cardiac emergency or an increase in metabolic function. In a respiratory emergency, oxygen administration enables the patient to reduce his ventilatory effort. When conditions such as atelectasis or acute respiratory distress syndrome impair diffusion, or when lung volumes are decreased
from alveolar hypoventilation, this procedure boosts alveolar oxygen levels. In a cardiac emergency, oxygen therapy helps meet the increased myocardial workload as the heart tries to compensate for hypoxemia. Oxygen administration is particularly important for a patient whose myocardium is already compromised—for instance, from a myocardial infarction or cardiac arrhythmia. When metabolic demand is high (in cases of massive trauma, burns, or high fever, for
instance) oxygen administration supplies the body with enough oxygen to meet its cellular needs. This procedure also increases oxygenation in the patient with a reduced blood oxygen-carrying capacity, perhaps from carbon monoxide poisoning or sickle cell crisis. The adequacy of oxygen therapy is determined by arterial blood gas (ABG) analysis, oximetry monitoring, and clinical examinations. The patient’s disease, physical condition, and age help determine the most appropriate method of
administration. Preparation of Equipment Although a respiratory therapist typically is responsible for setting up, maintaining, and managing the equipment, you’ll need a working knowledge of the oxygen system being used. Jul 21, 2016 | Posted by in NURSING | Comments Off on Oxygen Administration When administering oxygen therapy, it is important for the nurse to assess the patient before, during, and after the procedure and document the findings. Prior to initiating oxygen therapy, if conditions warrant, the nurse should briefly obtain a history of respiratory conditions and
collect data regarding current symptoms associated with the patient’s feeling of shortness of breath. The duration of this focused assessment should be modified based on the severity of the patient’s dyspnea. See Table \(\PageIndex{1}\) for focused interview questions related to oxygen therapy. This information is used to customize the oxygen delivery device and flow rate for the patient. For example, supplemental oxygen is typically initiated in nonemergency situations with a nasal cannula at
1-2 liters per minute (L/min), but a patient with a history of chronic obstructive pulmonary disease (COPD) may require a different device such as a Venturi mask. Please rate your current feeling of shortness of breath from 0-10, “0” being no shortness of breath and “10” being the worst shortness of breath you have ever experienced. Note: If the shortness of breath is severe, associated with chest pain, or if there are imminent signs of respiratory failure, discontinue the subjective assessment and obtain emergency assistance. Are you experiencing any additional symptoms such as chest pain, cough, or a feeling of swelling in your throat or tongue? Please describe. Note: If the patient describes severe symptoms that could indicate imminent blockage of the airway, obtain emergency assistance. When did it start? Is the cough productive of phlegm? If yes, what color and what is the amount? Does the chest pain radiate elsewhere? Have you ever been diagnosed with respiratory conditions such as asthma or COPD? Please describe. Are you currently taking any medications, herbs, or supplements to help you breathe? Please identify what you are taking and the dosage. If you are using inhalers on an as-needed basis, how often are you using them and has the frequency increased lately? Have you received oxygen therapy previously? Please describe. Do you use oxygen therapy at home? What is your normal flow rate? Do you use CPAP or BiPAP devices at home? Do you smoke? Have you considered quitting? Objective AssessmentPrior to applying supplemental oxygen, objective data regarding patient status should quickly be obtained such as airway clearance, respiratory rate, pulse oximetry, and lung sounds. Signs of cyanosis in the skin or nail bed assessment should also be noted. Within a few minutes after initiating oxygen administration, the nurse should evaluate for improvement of these indicators, and if no improvement is noted, then additional actions should be taken. At any point, if the nurse feels that the patient’s condition is deteriorating, emergency action should be taken such as calling the rapid response team or 911. Depending upon the severity of patient condition, serial ABG results may also be monitored to determine effectiveness of oxygenation interventions. After oxygen therapy is initiated, it is important to closely monitor for skin breakdown at pressure points. For example, nasal cannula tubing often causes skin breakdown in the nares or over the ears, so protective foam dressings may need to be applied. Life Span ConsiderationsChildrenDifferent sized oxygen equipment is used for infants and children. Additionally, oxygen tubing may need to be secured to a child’s face with tape to prevent them from pulling it off. For infants, the pulse oximeter probe is usually attached to the palm or foot. Older AdultsIf a patient is oxygen-dependent, ensure that extension tubing is applied so the patient is able to reach the bathroom with the oxygen device in place. However, be aware of the increased risk for falls due to the excess tubing. Keeping the oxygen tubing coiled up at the head of the bed or on the bedside table closest to the bathroom will decrease the patient’s risk of falling. Advise the patient to ask for assistance when getting up to use the restroom. 
What are the nurses responsibility during oxygen administration?Nurses have a responsibility to ensure that oxygenation is optimised at pulmonary and cellular level as part of their duty of care to patients. This requires knowledge of respiratory and cardiac physiology, as well as selection of the appropriate equipment and delivery method for supplemental oxygen therapy.
What nursing considerations should be made when delivering oxygen?Keep the oxygen at least five feet away from any heat source.. Avoid using equipment that could emit a spark.. Avoid wearing synthetic clothing due to static electricity.. Avoid use of flammable liquids.. No smoking.. Fire extinguisher readily available.. What are the general nursing interventions for the patient receiving oxygen therapy?Common Interventions to Improve Oxygenation. incentive spirometry.. chest physical therapy.. nasal cannula.. mechanical ventilation.. endotracheal tube.. tracheostomy.. closed chest drainage.. extubation.. What nursing considerations would you observe on a patient receiving supplemental oxygen?Objective Assessment. Prior to applying supplemental oxygen, objective data regarding patient status should quickly be obtained such as airway clearance, respiratory rate, pulse oximetry, and lung sounds. Signs of cyanosis in the skin or nail bed assessment should also be noted.
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What are the special nursing responsibilities during administration of oxygen?
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