oxygen by nasal cannula

1.	Goal: The patient will exhibit an oxygen saturation level within acceptable parameters. Identify the patient using at least two methods.
2.	Explain what you are going to do and the reason to the patient. Review safety precautions necessary when oxygen is in use. Place “no smoking” signs in appropriate areas.
3.	Perform hand hygiene.
4.	Connect nasal cannula to oxygen setup with humidification, if one is in use. Adjust flow rate as ordered by physician. Check that oxygen is flowing out of prongs.
5.	Place prongs in patient’s nostrils. Place tubing over and behind each ear with adjuster comfortably under chin or around the patient’s head, with adjuster at the back of the head or neck. Place gauze pads at ear beneath the tubing as necessary.
6.	Adjust the fit of the cannula as necessary. Tubing should be snug, but not tight against the skin.
7.	Encourage patient to breathe through the nose, with mouth closed.
8.	Reassess patient’s respiratory status, including respiratory rate, effort, and lung sounds. Note any signs of respiratory distress, such as tachypnea, nasal flaring, use of accessory muscles, or dyspnea.
9.	Perform hand hygiene.
10.	Put on clean gloves. Remove and clean the cannula and assess nares at least every 8 hours, or according to agency recommendations. Check nares for evidence of irritation or bleeding.