RLE Checklist Administering Oxygen by Cannula or Facemask

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Ateneo de Zamboanga University

COLLEGE OF NURSING
PERFORMANCE EVALUATION CHECKLIST
NAME: ___________________________________ DATE PERFORMED: _________________
YEAR & SECTION: ______________

ADMINISTERING OXYGEN BY CANNULA OR FACEMASK

Definition: Oxygen therapy is the administration of oxygen at a concentration of


pressure greater than that found in the environmental atmosphere.

Purpose: To increase oxygen saturation in tissues where the saturation levels are
too low due to illness or injury.

PREPARATION 1 2 34 5
Assess:
● Skin and mucous membrane color.
Note whether cyanosis is present.
● Breathing patterns.
● Chest movements.
● Chest wall configuration.
● Lung sounds.
● Presence of clinical signs of hypoxemia, hypercarbia, oxygen
toxicity.
Determine:
● Vital signs especially pulse rate and quality, respiratory rate, rhythm,
and depth.
● Whether the client has COPD.
● Results of diagnostic studies:
Hemoglobin, hematocrit, and complete blood count.
● Oxygen saturation levels, arterial blood gases,
pulmonary function tests.
● Need for oxygen therapy.
● Verify order for therapy.
 Perform a respiratory assessment to develop baseline data.
Assemble equipment:
Cannula
● Oxygen supply with a flow meter and adapter
● Humidifier with distilled water or tap water, according to agency
protocol
● Nasal cannula and tubing
● Tape
● Padding for the tubing
Facemask
● Oxygen supply with a flow meter and adapter
● Humidifier with distilled water or tap water, according to agency
protocol
● Prescribed face mask of the appropriate size
● Padding for the elastic band
Assist the client to a semi-Fowler’s position, if possible. RATIONALE:
This position permits easier chest expansion, hence, easier breathing.

Explain that oxygen is not dangerous when safety precautions are


observed. Inform the client and support people about the safety
precautions connected with oxygen use.

PROCEDURE
1. Introduce yourself and verify the client’s identity. Explain to the client
what you are going to do, why it is necessary, and how the client can
cooperate.
2. Perform hand hygiene.
3. Provide for client privacy.
4. Ensure that the flow meter is in the OFF position.
5. Attach the prescribed oxygen tubing and cannula to the humidifier.
6. Turn on the oxygen at the prescribed rate.
7. Check that the oxygen is flowing freely through the tubing. There should
be no kinks, and the connections should be airtight. There should be
bubbles in the humidifier as the oxygen flows through. You should feel
the oxygen at the outlets of the cannula or mask.
Cannula
8. Put the cannula over the client’s face, with the outlet prongs fitting into
the nares and the tubing around the back of the ears and secured
below the chin.
9. If the cannula will not stay in place, tape it at the sides of the face.
10. Pad the tubing over the ears and cheekbones as needed.
RATIONALE: Padding with a gauze pad helps to prevent irritation, and
relieve discomfort.
11. Assess the client’s nares for encrustations and irritation.
12. Assess the top of the client’s ears for any sign of irritation from the
cannula strap.
Facemask
13. Place the mask on the client’s face, and apply it from the nose
downward.
14. Fit the mask to the contours of the client’s face. RATIONALE: So very
little oxygen escapes.
15. Secure the elastic band around the client’s head so that the mask is
comfortable but snug.
16. Inspect the facial skin frequently for dampness or chafing. Dry and treat
it as needed.
17. Inspect the equipment regularly.
Check the liter flow and the level of water in the humidifier.
Be sure that water is not collecting in dependent loops of the tubing.
18. Document findings.
TOTAL

________________________
Clinical Instructor
(Sign over printed name)

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