Oxygen Delivery ORDER

Question 1

Nasal Cannula

Answer 1

Remove Cannula from package
Attach flow meter to oxygen connection on wall
Connect NC to flow meter
(If necessary: attach humidification to flow meter and attach nasal cannula connector end to humidification bottle)
Feel to ensure oxygen is flowing out of the prongs on the nasal cannula
Adjust flow meter to prescribed rate
Place prongs in patient’s nares (curved downwards), place tubing behind ears, adjust to secure under patient’s neck

Question 2

Simple Facemask

Answer 2

Apply mask starting at bridge of nose, covering mouth and chin
Be sure to have snug seal
Place elastic strap over patient’s head and let rest behind ears

Question 3

Partial Rebreather Mask

Answer 3

Be sure mask tubing is attached to flow meter and bag is partially inflated prior to applying to
patient (respiratory does the initial mask set up. Nurse is responsible for knowing that what was ordered is what the patient is receiving).
Apply mask starting at bridge of nose, covering mouth and chin.
Be sure to have a tight seal.
Place elastic strap over patient’s head and let rest behind ears

Question 4

Non-Rebreather

Answer 4

Be sure mask tubing is attached to flow meter and bag is partially inflated prior to applying to
patient
(respiratory does the initial mask set up. You are responsible for knowing that what was ordered is what the patient is receiving).
Apply mask starting at bridge of nose, covering mouth and chin. Be sure to have a tight seal.
Place elastic strap over patient’s head and let rest behind ears

Question 5

Venturi Mask

Answer 5

Apply mask starting at bridge of nose, covering mouth and chin. Be sure to have a tight seal.
Place elastic strap over patient’s head and let rest behind ears.
Observe for irritation behind ears and moisture around nose, face and chin where mask sits.
Gauze may be placed behind the ears to help alleviate pressure from the elastic strap.

Question 6

Metered Dose Inhaler: Prior to administration

Answer 6

Position patient into a high fowlers position (unless contraindicated patients with respiratory
complications cannot tolerate a supine position)
Do assessments
Check # of doses remaining, look at cannister for amount
Mark on calendar so patient doesn’t run out
Check expiration date

Question 7

Metered Dose Inhaler: Administation

Answer 7

-Place cannister into holder.
-Shake well (5-6 shakes)
-Remove cap
-Prime cannister (push down on cannister) if the cannister is new or hasn’t been used in a while
-Don gloves
-Have patient rinse their mouth out prior to using MDI (decreases the amount of bacteria on
mouth piece)
-Instruct patient to take a breath in and then out, place mouth piece into mouth and create a seal around mouth piece with their lips. Push cannister down (1 puff) and inhale for 3 - 5 seconds
- Remove canister from mouth
- Hold breath for 10 seconds
- Slowly exhale through pursed lips or through nose.
- If two puff are ordered of the same medication wait 1 minute between puffs
- If two different medications are ordered wait 5 minutes between medications
- Replace cap
- Bronchodilator first, then Corticosteroid (bronchodilators can cause tachycardia or palpitation, teaching the patient to
take their radial pulse will increase a patients autonomy)

Question 8

Metered Dose Inhaler (MDI) with a spacer

Answer 8

-Same steps as MDI
-Once you have placed the cannister in the holder and
primed (if necessary), place the MDI into the spacer
Rinse mouth.
- Remove cap.
- Have patient inhale and exhale.
- Place mouthpiece into patient’s mouth and have them seal around the mouth piece with their
lips.
- When using a spacer press cannister to instill medication into spacer and then have patient inhale slowly
- Hold for ten seconds.
-* Remove spacer from mouth and exhale slowly through pursed lips or through nose.
-* If a corticosteroid was administered have patient rinse their mouth.
-* Post-protocol

Question 9

Nebulizer

Answer 9

Same procedure for MDI and spacer
-Place the compressor on a solid surface near an electrical outlet and plug in.
-* Connect air tubing to nebulizer base.
-* Attach mouthpiece and cup to the t-shaped connector.
-* Unscrew top from cup and place the correct dose of medication into cup, replace top.
-The pictures below show the medication in individual soft plastic containers, the top twists off and you squeeze the medication into the cup (regardless of how the pharmacy dispenses the
medication the correct dose goes into the cup
-Turn on nebulizer.
-* Be sure you have a mist
- Instruct patient to keep the cup upright
* Instruct patient to close lips tight around mouthpiece
* Encourage patient to breathe deeply
(They can breathe normally
when receiving the treatment but encourage them to breathe deeply).
- Have the patient flick the side of the cup with their
finger to allow condensation of the medication to fall back into the cup.
- Continue until there is no longer a mist (you will hear a gurgling/spitting
sound)
- Remove nebulizer from mouth and turn off compressor