Definition
Oxygen therapy via nasal cannula is one of the most common and comfortable methods for delivering supplemental oxygen to patients who need respiratory support but can still breathe on their own.
A nasal cannula is a thin, flexible tube with two small prongs that fit into the nostrils. It connects to an oxygen source (like a tank or concentrator) and delivers oxygen directly into the nasal passages. It allows patients to talk, eat, and drink while receiving oxygen making it ideal for long term or low flow therapy.
Purpose
- To relieve dyspnea
- To administer low concentration of oxygen to patients.
- To allow uninterrupted supply of oxygen during activities like eating, drinking, etc.
Articles
- Oxygen source.
- Nasal cannula with connecting tubes.
- Humidifier with distilled water.
- Flow meter.
- Gauze pads.
- No smoking” signs.
Procedure
| Nursing Action | Rationale |
| Before procedure Determine the need for oxygen therapy in patients. Check physician’s order for rate, device used concentration, etc. Perform an assessment of vital signs, level of consciousness, laboratory values, etc. and record. Assess risk factors of oxygen therapy in patients and environment such as patients with hypoxia drive, faulty electrical connection, etc. Explain procedure to patient and relatives and inform them how to cooperate. Post a ‘no smoking” sign on the patient’s door in view of the patient and visitors and explain to them the dangers of smoking when oxygen is on flow. | Reduces the risk of error in administration. Provides a baseline for future assessment. Reduce the risk of danger to the patient Reduces anxiety and ensure cooperation Oxygen support combustion, smoking in oxygen area can lead to fire hazards. |
| During procedure: Wash hands. Reduces risk of transmission of microorganisms. Set up oxygen equipment and humidifier. a. Fill humidifier up to the level marked on it with sterile water. b. Attach flow meter to source, set flow meter in “off” position. c. Attach humidifier to base of flow meter. d. Attach tubing and nasal cannula to humidifier. e. Regulate flow meter to prescribed level. f. Ensure proper functioning by checking for bubbles in humidifier or feeling oxygen at the outlet. Place tips of cannula to patient’s nares and adjust straps around ear Proper fixing ensures comfort and prevents chances of cannula slipping for snug fit. The elastic band may be fixed behind the head or under chin. Pad tubing with gauze pads over ear and inspect skin behind ear periodically for irritation/ breakdown. Inspect patient and equipment frequently for flow rate, clinical condition, level of water in humidifier, etc. Ensure that safety precautions are followed. | Reduces risk of transmission of microorganisms. Filling beyond this point will cause water to enter the tubing. The flow meter helps in monitoring and regulating oxygen flow to patients. Humidification helps in preventing drying of mucous membranes and promotes comfort of patients. Oxygen is a drug and is dangerous to administer at flow rates greater or lesser than prescribed level. Kinks in the tubing will obstruct the flow of oxygen through the tube. Proper fixing ensures comfort and prevents the chance of cannula slipping from nostril. Constant pressure may cause skin breakdown. Helps in identifying any complications that may arise. |
| After procedure Wash hands Document time, flow rate, and observations made on patient. Encourage patient to breathe through his/her nose with mouth closed. Remove and clean the cannula with soap and water, dry, and replace every 8 hours. Assess nares at least every 8 hours. | Provides of optimal delivery of oxygen to patient. The presence of cannula causes irritation and dryness of the mucous membrane. |
Special Precautions
1. Never deliver more than 2-3 litres of oxygen to patients with chronic lung disease, e.g., COPD.
2. Check frequently that both prongs are in the patient’s nares.
3.Ensure safety precautions are in place, e.g, placing ” No smoking” sign at the patient’s bedside.
4. Oxygen concentration will vary on the basis of several factors like patient’s tidal volume and ventilatory pattern.
| Flow rate | Oxygen concentration |
| 1 liter | 24 – 25% |
| 2 liters | 27 – 29% |
| 3 liters | 30 – 33% |
| 4 liters | 33 – 37% |
| 5 liters | 36 – 41% |
| 6 liters | 39 – 45% |
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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