How to give topical medications

A.M.Karunaratne Attanayake
Special Grade Nursing Tutor
College of Nursing
Badulla - Sri Lanka.
amkaru.sp@gmail.com
2/3/2016 1

What are the topical
medications?
 Topical medications are administered
directly to the SKIN and MUCOUS
MEMBRANES by painting or spreading it
over an area, applying moist dressings,
soaking body parts in a solution, or giving
medicated baths.
 Applied to produce local effects, some
topical preparations have systemic effects,
absorbed through the skin and mucous
membrane.
 Systemic effects more, if skin – very thin
and drug concentration high or skin contact
– prolonged.
2/3/2016 2

What are the topical medications?
Ctd……..
 Medications such as Nitroglycerin ,
Estrogen applied topically by transdermal
disk or patch.
 Mucous membrane used by route of
administration of drugs for quickly
absorbed.
 Mention as above systemic effects occur,
whenever the concentration of the drug is
high or more quantity of drug is
administered.
2/3/2016 3

What are the topical medications?
Ctd……..
 Mucous membrane at different regions
differ in their sensitivity to drugs.
 The cornea of the eye and nasal mucous
membrane are very sensitive. The patient
will be complain of burning sensation ,
when apply of eye and nasal drops.
 Vaginal and rectal mucosa are not very
sensitive and medications are less
irritating.
2/3/2016 4

Methods of application of
medications
1. Direct – liquid - EYE DROPS, SWABBING
OF THROAT, GARGALING.
2. Insertion – drug into the body cavity –
SUPPOSITARY TO THE RECTUM.
3. Instillation ( Slow introduction ) , fluid
into a body cavity - EAR DROPS, NASAL
DROPS
4. Irrigation ( washing out of body cavity) –
BLADDER IRRIGATION.
5. Spaying – into the THROAT.
2/3/2016 5

Instillation ( Slow
introduction ) , fluid into a
body cavity -EAR DROPS
2/3/2016 7

Instillation ( Slow introduction ) ,
fluid into a body cavity - NASAL
DROPS
2/3/2016 8

Irrigation ( washing out of body cavity)
– BLADDER IRRIGATION.
2/3/2016 9

 INNUNCTION is the act of rubbing an oily
or fatty preparation into the skin make
produce a local effect as CLEANING,
SOOTHING , DISINFECTING or
RELEAVING a local inflammation.
 Lotions and Ointments are used for
inunction.
2/3/2016 11

I. The area of the skin should be thoroughly
cleaned before the application of an
ointment or lotion.
II. The ointment or lotion should be ‘ rubbed
in ’ instead of ‘painted on ’ to achieve a
therapeutic effect.
III. A lotion should be shaken well first, then
applied on the skin and allowed to dry.
next…..page
2/3/2016 12

IV. The lotion tend to flake and fall off , they
have to be reapplied as necessary. Before
the re-application , the lotion or ointment
should be completely removed from the
skin.
V. The skin observe frequently after the
application of ointment or lotion for any
local skin irritation. Any skin irritation
report immediately and application be
discontinued.
VI. A thin coating of ointment is prefer to a
thick layer, both for the economy of
medications and for efficiency.
next page…….
2/3/2016 13

VII. The nurse use a sterile/clean gloves
depending upon the condition of the skin.
The use of gloves of will prevent the cross
infection and the effect of the treatment on
the nurse.
VIII.When ointments are taken from large
containers , prevent contamination of the
stock jar. Take only sufficient medications
for one application to the patient unit in
order to prevent wastage. Once the
applicator has touched the skin, never
placed back into the container as
contamination of the entire bottle may take
place.
next page….
2/3/2016 14

IX. When lotion and ointments are applied ,
avoid introducing them into the EYES ,
MOUTH, RESPIRATORY PASSAGES
X. Look for the special instruction on the
label. Follow these instructions carefully
for a therapeutic effect.
XI. No ointment or lotion should be applied
on any patient without the doctor’s
orders.
2/3/2016 15

lotion should be ‘ rubbed
in ’ instead of ‘painted on ’
2/3/2016 16

 It is the method of placing medication into
area of mucous membranes for either
local or systemic effects is called
“INSERTION” eg. NITROGLYCERIN tabs
are inserted into tongue for – relief angina
pain, suppositories into rectum or vagina
as laxative or as antiseptics.
 When keep the sublingual tabs – patient
understand not to chew or swallow – must
be slowly dissolved and absorbed
through Blood vessels.
2/3/2016 17

 The act of drawing an AIR, VAPOR, OR GAS
into the Lungs.
 Medications inhale for,
 LOCAL EFFECT ( Steam inhalations for relieve
congestion in the Respiratory Tract )
 GENERAL EFFECT ( Inhalation of Oxygen,
Anesthetics)
 Two Types of Inhalations
 DRY INHALATION
 MOIST INHALATION.
2/3/2016 18

 It is belonging the Inhalation of GASES,
FUMES from volatile medications or Burning
Medications. E.g.
i. Inhalation of General Anesthetics – Either,
Chloroform, Nitrous Oxide ( using mask )
ii. O2 and CO2 Inhalation -(mask ,tent, catheter)
iii. Inhalation of Volatile Medications – such as
menthol, aromatic spirits
iv. Inhalation of Strammonium and Belladona
v. Aerosol Spray – a fine suspension of liquid
– Respiratory Tract. Nebulizers are used.
2/3/2016 19

 Breathing warm and moist air.
 The produced vaporizer – called STEAM /
MOIST INHALATION.
 The steam inhalation – moisture and the
heat , medicines also can use for acting
as a respiratory antiseptics.
2/3/2016 20

I. To relieve the Inflammation and
Congestion of the mucous membrane of
the respiratory tract and paranasal
sinuses
II. To make symptomatic relief in acute cold
and sinusitis.
III. To soften thick , tenacious mucous and
help them expulsion from the respiratory
tract.
IV. To relieve symptoms of cough in
bronchitis , and in post operative cases.
2/3/2016 22

V. To provide heat and moisture and to
prevent the dryness of the mucous
membranes of the lung and upper
respiratory passages following operations
such as tracheostomy.
VI. To help in the absorption of Oxygen.
VII. The relieve spasms of the larynx and
bronchus and bronchioles.
VIII.To provide antiseptic action on the
respiratory tract. E.g. by using menthol ,
tincture benzoin etc.
2/3/2016 23

 Tr. Benzoin – 5ml per 500ml of boiling
water.
 Methyl salicylate – few drops per 500ml of
boiling water.
 Menthol - few crystals per 500ml of
boiling water.
 Camphor – few crystals per 500ml of
boiling water.
2/3/2016 24

Now we see the methods using
to give STEAM INHALATION.
Use 03 Methods
 Using by JUG METHOD.
 Using by STEAM TENT.
 Using by ELECTRIC STEAM
INHALER.
2/3/2016 25

 A Nelson’s Inhaler is used.
 In this method inhalent require and the
boiling water filling the jug(inhaler) and
the patient breaths vapour.
 At the home ( no nelson’s inhaler) patient
can be taught to modified the jug. A tea
kettle or a mug fill with boiling water and
the inhalent. A cone is made with
cardboard and fit over the kettle or a mug.
 A small hole cut on the top of cone and
breaths in the steam.
2/3/2016 26

 This method is used for when a high
concentration of steam is required.
 There are different methods use a making
tent.
 The quick and easy method – place a
screen on either sides on the patient’s bed
and stretch blankets or sheets across
them and fix with safety pins and forming
canopy. Steam can be directed in to the
tent from the spout of a kettle.
Ctd…. With Next slide…….
2/3/2016 27

 Care should be taken that the stove and
the kettle are placed for AWAY FROM THE
SCREEN and THE BED CLOTHES to
prevent of fire.
 Never point the spout towards the face of
the patient.
 A child never be near to the steam
generating apparatus to get child’s hand
into the steam jet.
 The steam is given for 20 – 30minutes ,
repeat every 04hrly.
2/3/2016 28

 Small electric vaporizer is used to give
steam inhalation.
 A small jar with a heating element extending
into the jar. The jar is filled with water, top of
the jar is a removable perforated cup to
which is attached a small metal spout.
Cotton saturated with medication is placed
inside the cup and metal spout is fitted over
the cup. As the water boils, the medication
steam is directed through the spout is
inhaled by the patient.
2/3/2016 29

Follow the instructions when
giving THE STEAM INHALATION
 REMEMBER – danger involved of scalding
the patient by STEAM or BOILED
WATER COMING OUT of the inhaler.
Important when the patient is , very old,
Very young, actually ill or in state of
confusion. The spout of the inhaler placed
in that the patient can’t touch it or put the
patient’s face too near.
next slide…
2/3/2016 30

 When jug or kettle is used , fill it only 2/3 of
boiling water to prevent scalding of the
patient. If the inhaler is filled to the brim,
possible to draw water into the mouth and
scalding the patient. The water must be
remained just below the spout. If the spout
is filled with the water , it will not act as an
air inlet, the patient will not get warmed air.
 Always remember the danger of fire. If a
stove is used with a kettle to generate
steam continuously ,as steam tent, the
blankets used may fall on the stove and
catch fire.
See Next slide.
31

 The temperature for jug method – 120 –
1600F , If water is cold, not produced
steam. If water is too hot , cause scalding
of the patient.
 Keep the patient – warm and prevent
DRAUGHT before, during and after the
inhalation.
 Causing the treatment is the blood vessels of
the skin and mucous membrane dilate and the
patient is easily chilled by exposed to draught.
It will patient to more severe and prolonged
attack of inflammation and congestion. The
patient not to go into cold spaces for several
hours after treatment. Remain in the bed.
2/3/2016 32

 If volatile drugs are used ( e.g – Menthol )
warm the patient to keep his eyes closed to
prevent the drug irritating the conjunctiva.
 Observe the patient closely throughout the
procedure for adverse effects.
 When give inhalation by jug method , keep
spout away from the patient.
 Place the sputum cup in the reach of the
patient to spit the coughed up during the
inhalation.
 Explain the procedure to the patient before
preparation of the inhalation. Not during
procedure.
2/3/2016 33

Preliminary Assessment:
 Check the patient’s Name, BHT ,
for identifications.
 Find the medical diagnosis and
general condition of the patient.
 See the physician’s orders to
find the specific precautions
of movements and position.
2/3/2016 34

 Assess the patient’s ability for self
care , move, and maintain the relevant
position.
 Assess the level of consciousness and
the ability to follow given instruction
by nurse.
 Find out the articles available in the
patient’s unit.
2/3/2016 35

Articles Purpose
1. Nelson’s inhaler with
mouth piece , tightly fit
to the neck of the
inhaler
1.To use as a vaporizer
2. Bowel or basin –
hold the inhaler
2. To place the inhaler
safety.
3. Flannel/Towel 3. To wrap the inhaler
for prevent heat loss
4. Face towel 4. To wipe the face
2/3/2016 36

5. Bath Blanket or bath
towel
Put over patient’s
head ,
6. Tincture benzoin or
any other inhalant
ordered.
Used as a respiratory
antiseptic.
7. Teaspoon or a
minim glass.
To measure the
inhalant.
8. Kettle- boiling water.
9. Gauze piece. To wrap the mouth.
10.Cotton swab To plug the spout.
11. Kidney tray /paper To collect wastes.
2/3/2016 37

 Explain the procedure – get confidence and
cooperation of the patient.
 Explain sequence of the procedure and tell
patient how can take the inhalation.
 Make the patient understand that remain in
the bed one – two hours more after
inhalation.
 Ask the patient want to go to the wash
room and empty the bladder and bowels.
For bed ridden patient , offer bedpan/urinal.
2/3/2016 38

 Keep patient in a fowler’s position with
bed table. If the movements are restricted,
keep the patient in a side lying position or
any position is comfortable to patient. ( eg.
Sitting with a pillow on the lap )
 Close the doors and windows and put off
the fan to prevent draught.
 Place the sputum cup in a convenient
place within the easy reach of the patient.
 Provide the face towel to wipe the
sweating from the face during the
inhalation.
2/3/2016 39

Steps of procedure Rationale
1. Measure the capacity
of inhaler with water. ½
- 2/3 filled capacity.
To determine the
amount of inhalant.
2. Warm – inhaler by
little hot water into the
jug and emptying it.
To maintain the
temperature of the
water , constantly.
3. Pour the required
amount of inhalant and
filled the jug 2/3 with
hot water, below spout.
If inhaler filled to the
brim , possibility of
drawing water to
mouth and scalds.
2/3/2016 40

4. Place the mouth
piece and close the jug
tightly . See the mouth
piece is in the opposite
direction to the spout.
Keep the spout away
from the patient when
inhalation is taken.
5. Cover the mouth
piece and plug the
spout with cotton ball.
To prevent burns of lip.
Cotton ball in spout
prevent escape steam.
6. Cover the jug with a
flannel piece or a towel
To insulate the jug and
to prevent the heat loss.
7. Place the inhaler in
the bowel and take bed
side without losing time
Placing the jug in the
bowel reduces the
chances for burns.
2/3/2016 41

8. Place the apparatus
conveniently in front
of the patient with the
spout opposite to the
patient. Remove
cotton plug.
To reduces the
chances of burns.
Removing cotton plug
helps to keep up
patency of spout for
the air.
9. Instruct - place the
lip on mouth piece and
breath in the vapor.
Breath Steam - nostrils
Relieve the congestion
of mucous membrane.
Cover the patient’s
head and jug with a
bath blanket or a towel
To help collect steam
around the face, steam
concentration increase
2/3/2016 42

 Continue treatment for - 15 to 20 minutes.
 Remove the inhaler , after stated time,
Wipe off the perspiration from the face.
 Remove – back rest , bed table. Adjust
position of the patient in bed. Make
comfortable. Tidy up the bed.
 Instruct patient to remain in bed for 1-2hrs
to prevent draught.
see next slide…
2/3/2016 43

 Take the articles to the utility room. Empty
the inhaler, clean, wash with warm soapy
water. Rinse with clean water. Removing
the gauze covering the mouth piece and
clean the mouth piece thoroughly. Boil
mouth piece to prevent cross infection. All
the other articles are washed soapy water
and clean water. Dry and replace proper
place. Wash hands.
 Record the procedure on nurse’s notes
with date ,time, patient’s response to the
procedure.
 Return to patient, assess comfort, offer
hot drink if needed.
2/3/2016 44

 Patients with respiratory impairment are
treated by Oxygen Inhalation – relieve
HYPOXAEMIA ( deficiency O2 in the blood)
 The normal amount of O2 in arterial blood –
80-100mmHg.
 If fall these to below 60mmHg - irreversible
physiologic effect occur.
 Tissues vary O2 requirements. Cerebral cell
get 20% of body body’s O2 supply and live
only few minutes ( 5-7min) for cutoff O2
2/3/2016 45

1. Cyanosis : bluish colour of the skin, nail
beds and mucous membranes, resulting
from a decreased amount of oxygen in the
Hemoglobin of the blood.
2. Breathlessness : caused by disease such
as asthma, emphysema, pulmonary
embolism, coronary thrombosis, cardiac
insufficiencies.
3. An environment low in oxygen content :
high altitudes
2/3/2016 47

4. Anemia : deficiency of either quality or
quantity of red corpuscles in the blood
giving rise to symptoms of anemia.
5. Diseases or condition in the oxygen
across the alveolar-capillary membranes
– pulmonary edema, pneumonia, chest
trauma.
6. Patient with respiratory capacity is
diminished by diseases or conditions :
atelectasis , pneumenectomy,
thoracoplasty.
7. Poisoning – chemical alter the tissue’s
ability to utilize oxygen , cyanide
poisoning.
2/3/2016 48

8. Shock and respiratory failure.
9. Hemorrhage and air hunger.
10. Patient under anesthesia.
11. Patients who are critically ill.
12. Patients with psychologically induced
breathlessness.
13. Asphyxia :condition in lack of oxygen in
the lungs leading to unconsciousness
caused by blocking of the air passage by
foreign bodies, drowning, electrical
shock, strangulation, inhalation of
poisonous gases.
2/3/2016 49

 Depending factors
2/3/2016 51
1. Condition of the patient
2. The concentration to be given
3. The facillitate available
4. Preference of the physician

 A simple comfortable device. The two
cannula about 1.5cm (1/2inch) long,
protrude from the center on the tube end
and insert into the nares. Flow rate up to
4L/min.
2/3/2016 52

 Most common Method.
 Catheter inserted into the nostril reaching
up to the uvula.
 Catheter not interfere the patients freedom
to eat , talk , move on the bed.
 Flow – 1 -4 L/min – 22% - 30% oxygen.
 Catheter changed – 8hrly.
2/3/2016 54

 A devised used to administer oxygen ,
humidity or heated humidity.
 Two primary types of mask.
 High concentration
 Low concentration
 Masks are advantageous for patient with
unable to breath through the nose.
 B.L.B. ( Boothby , Lovelace and Bullbulian)
masks - rebreathing bags consisting of a
face mask attached to a reservoir bag.
2/3/2016 56

 A plastic face mask with a reservoir bag
and a venturi mask – capable of delivering
higher concentration of oxygen. When use
as a non – breather , the plastic face mask
with a reservoir can deliver from 80% -
90% oxygen, ( 70% when used as
rebreather ) with a flow rate of 10L/min.
 The venturi mask – deliver oxygen
concentration of 24% to 28% , 30%,35%,
40%, 55% with oxygen flow rates of 2 to
3,4,6,8.14L.min
 Simple face mask – short oxygen therapy.
30 – 50% , flow rate 8 to 12L/min
2/3/2016 57

 Canopy over the patient’s bed that may
cover the patient fully or partially , and
connected to a supply of oxygen.
 Canopy – transparent , observe for nurses.
 Advantages of using oxygen tent:
 Provide environment for the patient with
controlled oxygen concentration , temperature
regulation and humidity controlled.
 Allows freedom for free movement in bed.
2/3/2016 61

 Disadvantages of using oxygen tent:
 Create a feeling of isolation.
 Requires high volume of oxygen ( 10 – 12
L/min ) , cannot be made available ordinarily.
 Loss of desired concentration occurs each
time the tent is opened to provide care for the
patient.
 There is an increased chances of fire.
 Requires much time and effort to clean an
maintain a tent.
The “infant incubator” is like an oxygen
tent designed to maintain a constant
temperature.
2/3/2016 62

 A method used for delivery of oxygen to
chronic lung diseases, insert – small IV
catheter directly into the trachea through a
surgical tract in the lower neck.
 Advantage in patient with require continuous
oxygen administration for following reasons.
 Less expensive – No loss of oxygen
 Oxygen reaches directly – adequate oxygenation.
 Patient tend to use oxygen – mobility, comfort and
cosmetic improvement.
 Additional humidification is not needed.
2/3/2016 63

O2
Supply
by,
Cylinder of Tanks
Store under pressure of
2200pounds ( 1000kgs) per
sq.inch.
Hospital provide piped in
oxygen.
2/3/2016 65

 Use the cylinders with a metal case to
prevent the danger of falling and breaking
 Placed at the head end of the bed, away
from the traffic areas likely to be knocked
down.
 Any sources of fire should be kept away
from the cylinder. Oxygen is not
explosive, but it supports combustion,
that a spark of flames can cause a major
fire.
2/3/2016 66

2/3/2016 67
 Store – cool , away from heaters. ( high
Temp. expansion of the gas, loss gas
through safety valves )
 The supply of oxygen must always be
equipped with a regulator to control flow.
 Avoid grease on the regulator – in high O2
concentration tend to fire and explode.
 Every Nurse , PATIENT, his FAMILY
members and VISITORS aware of the
danger of fire and explosion in an oxygen
therapy unit. WARNING SIGNS indicate -
NO SMOKING , ultra sound electric
devices and open flames banned. Teach
the patient/visitors- danger.

 CYLINDER – EMPTY , MARK – ‘ EMPTY’
and Send for filling.
 Inspect the apparatus at frequent interval
and make sure for its good working
condition.
 The nurse should learn working of
cylinders, regulators, etc. The cylinder is
opened by turning the large valve at the
end of the cylinder with a spanner, by
turning it anti-clock wise. The wheel valve
at the side of regulator is opened by
turning at anti-clockwise.
 To test any leakage – regulator , soap
lather used , if leak – bubbles are seen.
2/3/2016 68

 Infection
 Combustion ( fire )
 Dry – mucous membrane of respiratory tract
 Oxygen toxicity
 Atelectasis
 Oxygen induced apnea
 Retrolental fibroplasia – for premature infant
 Asphyxia
2/3/2016 69

 Since O2 acts as a drug, must be prescribed
and administered in specific dose in order
to avoid O2 toxicity. ( concentration and rate
of flow )
 Using an oxygen cylinder , use a regulator
and humidifier.
 Regulator – to reduce the pressure of the
oxygen in cylinder to a safer level. Flow 2-4L/m
 Humidifier – saturate the O2 with water vapor to
prevent the drying of the mucous membrane of
respiratory tract.
2/3/2016 70

 Every part of the apparatus – clean to
prevent infection. Use disposable catheter.
 Change the nasal catheters – at least 8hrs.
 During the administration of oxygen –
valve controlling the rate of flow should
not be handled.
 Oxygen administration never stop until the
factors that caused hypoxia are reversed.
 When oxygen therapy is discontinued,
done gradually. The patient is weaned
from dependence on oxygen by reducing
the dosage and then administering it
intermittently.
2/3/2016 71

 All patients receiving oxygen inhalation ,
Temp. taken rectally to get an accurate
record of body temperature.
 The nurse leaves the patient - call signal
near patient.
 Pay attention to condition that can
interfere with the flow of oxygen from the
source to a patient., kinks in the tubing,
loose connection , faulty humidifying ,
 To prevent the deprivation of oxygen
resulting from the depletion of oxygen
from the cylinder, - get new one ready at
hand
2/3/2016 72

 For fear of rectolental fibroplasia the
premature babies are given oxygen
inhalation only for a short period at a very
low concentration.
 Watch the patients receiving oxygen therapy
continuously to detect the early sigs of
oxygen toxicity.
 When oxygen is administered through nasal
catheters, the catheter is not directed
beyond the uvula to prevent distention of
abdomen.
 Fire precautions are taken when O2 on flow.
2/3/2016 73

 PRELIMINARY ASSESSMENT
 Check – Name, BHT, identification of patient
 See –diagnosis and the need for O2 therapy.
 Check the doctor’s orders for the initiation
of the of the therapy, the dosage ( L/minute)
 Check the specific precautions regarding
the movement and positioning of the
patient.
 Assess the patient – signs of clinical anoxia
2/3/2016 74

 Assess the patient’s vital signs and the
breathing patterns carefully before
starting the therapy.
 Check the results of arterial blood gas
analysis.
 Note any signs of pulmonary dysfunction.
 Inspect the anterior nares for encrustation
and irritation.
 Inspect the skin on the nose and the
surrounding areas for any skin lesions.
 Check – patient’s mental state and ability
to follow instructions.
 Check – articles available in the unit.
2/3/2016 75

Articles Purpose
A. Oxygen Cylinder-
stand, regulator, flow
meter, humidifier,
connecting tube )
B. A Tray containing:
i. Nasal catheter
ii. Lubri: jelly (W.S.)
iii. Adhesive tape
iv. Bowl of water
v. Flash light
To administration O2.
To lubricate catheter.
Catheter in place.
To test O2 flow.
Assess placement.
2/3/2016 76

vi. Tongue depressor
vii.Cotton applicators
and normal saline
in a container.
viii.Kidney tray and
paper bag.
ix. Mackintosh and
towel.
x. Rag piece or
gauze piece in a
container.
To clean the nostrils
To receive the wastes
and used tongue dep.
To protect the
garment and clothes
To wipe off the
secretions from the
nose and mouth
during the procedure.
2/3/2016 77

 Explain procedure – get co operation and
confidence. Explain sequence of procedure.
Relieve anxiety. Explain purposes.
 Instruct – patient, family , visitors, safety…
 Remove – cigar, matches , electric app.
 Assemble – articles conveniently in the unit.
 Place patient –comfortable fowler’s position
 Clean nostrils – if crust
 Protect the bed and garments - towel
2/3/2016 78

Steps of procedure Rationale
1. Wash hands
2. Measure – catheter.
Tip of the nose to
ear lobe.Mark length
3. Check – apparatus
working, open main
valve, open wheel
valve. Adjust flow.
To prevent cross
infection
From anterior nares to
level of uvula. If not
reach oropharynx O2
loss by open mouth.
Checking apparatus
before inserting the
catheter. Find oxygen.
2/3/2016 79

4. Lubricate the tip of
catheter sparingly
with water soluble
jelly and check
flow.
5. Introduce catheter
slowly one nares.
Never use force
6. Check – position
catheter in
oropharynx.
7. Fix the catheter-
forehead/cheek
Lubricate prevent
irritation of nasal
mucosa. Check flow of
oxygen again under
the water.
Force cause injury.
Also can kinking of
tube in nasal cavity.
Make sure catheter is
correct place and not
kinked.
Prevents displacement
when patient move.
2/3/2016 80

 Stay with patient till – ease.
 Keep – warm and comfortable of patient.
 Evaluate – patient’s progress, by checking
vital signs and colour.
 Record the procedure- date, time, on nurses
notes, patient’s response also record.
 Check apparatus - flow, level of humidifier,
safety measures.
2/3/2016 81

 Arrange – blood gas analysis , state of
anoxaemia is treated.
 Change – nasal catheter – every 8hours
or more frequently.
 When the oxygen is to be stopped, do it
gradually. Reduce the volume of oxygen
1st, then give it intermittently.
 To discontinue – loosen adhesive tape
and take out catheter. Close main valve.
Discontinued catheter put the kidney tray.
 Watch – patient for any deteriorating
symptoms after remove oxygen inhaltion.
2/3/2016 82

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