Oxygenation

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Oxygenation

  1. 1. Oxygenation0 Oxygenation is a basic human need0 Breathing is synonymous to life, thus, oxygen is required to sustain life0 2 body systems that supply the body’s oxygen demands 0 Cardiovascular system 0 Respiratory system
  2. 2. Respiratory System0 The lung transfers O2 from the atmosphere into the alveoli, where the O2 is exchanged for CO20 The alveoli transfers O2 and CO2 to and from the blood through the alveolar membrane
  3. 3. Pulse Oximetry0 Noninvasive0 Estimates arterial blood oxygen susturation (SpO2)0 Normal SpO2 95-100%0 < 70% - life threatening0 Detects hypoxemia (low oxygen; more in blood) before clinical0 Sensor, photodetector, pulse oximeter unit
  4. 4. Pulse Oximetry0 Factors that affect accuracy include 0 Hemoglobin level 0 Circulation 0 Activity 0 Carbon monoxide poisoning
  5. 5. Respiration0 Processes 0 Ventilation 0 Diffusion 0 Perfusion
  6. 6. Ventilation0 Factors influencing ventilation 0 Adequate atmosphere oxygen 0 Clear air passages 0 Adequate pulmonary compliance and recoil 0 Regulation of respiration
  7. 7. Diffusion0 Factors influencing diffusion of gasses 0 Thickness of membrane 0 Surface area of the membrane 0 Diffusion coefficient of gasses 0 Pressure gradient on each side of the membrane
  8. 8. Perfusion0 Factors affecting oxygen transport from lungs to the tissues 0 Cardiac output 0 Number of erythrocytes 0 Exercise 0 Blood hematocrit
  9. 9. Factors Affecting Oxygenation0 Environment (altitude, heat, cold, air pollution)0 Exercise0 Emotions (fear, anxiety, anger)0 Lifestyles (smoking, occupations, sedentary life, etc)0 Health status (anemia [low red blood cells] respiratory) Narcotics (morphine, demorol, etc)
  10. 10. 3 Major Alterations in Respiratory Functions0 1. Hypoxia 0 Respiratory insufficiency 0 Acapnea (absence of CO2 in blood) 0 Hypocarbia 0 Depressed level of CO2 in the blood 0 Hyperpnea (rapid breathing) 0 Hypopnea (slow breathing)
  11. 11. Signs of Hypoxia0 Early/ acute signs 0 Restlessness 0 Increased pulse rate 0 Increased rate and depth of respiration 0 Increase in systolic blood pressures
  12. 12. Signs of Hypoxia0 Late/chronic signs 0 Decreased pulse rate 0 Decreased systolic blood pressure 0 Dyspnea 0 Fatigue and lethargy 0 Cough 0 Hemoptysis 0 Clubbing of fingers
  13. 13. 3 Major Alterations in Respiratory Functions0 2. Altered breathing patterns 0 Rate 0 Volume (hypo or hyper) 0 Rhythm (Cheyne Stokes, Kussmaul’s, Apneustic, and Biat’s) 0 Relative case of effort respiration (dyspnea and orropnea)
  14. 14. 3 Major Alterations in Respiratory Functions0 3. Obstructive or particularly obstructive airways 0 Upper airway, obstruction 0 nose, pharynx, larynx, trachea
  15. 15. NANDA Nursing Diagnosis Related to Oxygenation0 1. Ineffective airway clearance 0 Refers to inability of the individual to clear secretions or obstruction from the respiratory tract to maintain airway patency 0 Tracheobrachial infections 0 Obstructions, secretions
  16. 16. NANDA Nursing Diagnosis Related to Oxygenation0 2. Ineffective breathing pattern 0 Refers to and individual’s inhalation or exhalation pattern that inhibits adequate ventilation 0 Neuromuscular 0 Pain, anxiety 0 Decreased energy and fatigue 0 Inflammatory process
  17. 17. NANDA Nursing Diagnosis Related to Oxygenation0 3. Decreased cardiac output 0 State in which the blood pumped by the heart is sufficiently reduced that it is inadequate to meet the needs of the body 0 Structural alteration 0 Ventricular – septal rupture, valvular disease
  18. 18. NANDA Nursing Diagnosis Related to Oxygenation0 4. Impaired gas exchange 0 State in which there is an imbalance between O2 and CO2 elimination at the alveolar capillary membrane gas exchange area 0 Altered O2 supply 0 Altered blood
  19. 19. NANDA Nursing Diagnosis Related to Oxygenation0 5. Altered tissue perfusion 0 State in which an individual experiences a decrease in nutrition and oxygenation at the cellular level because of a deficit in capillary blood supply 0 Interrupted venous or arterial flow 0 Hypo/hyper volemia
  20. 20. Measures That PromoteAdequate Respiratory Function0 1. Ensure a patent airway 0 To promote gaseous exchange between client and environment 0 Check for obstructions 0 Foreign objects, mucus0 2. Positioning 0 To allow maximum chest expansion 0 Fowler’s position 0 Encourage frequent changes
  21. 21. Measures That PromoteAdequate Respiratory Function0 3. Deep breathing and coughing exercises 0 To promote lung expansion and loosen secretions 0 E.g. abdominal breathing (diaphragmatic and pursed lip)0 4. Adequate hydration 0 Maintain moisture of the respiratory mucus membrane 0 Use of humidifiers/ nebulizers 0 Steam/ aerosol/ medimist
  22. 22. Measures That PromoteAdequate Respiratory Function0 5. Chest physiotherapy 0 Percussion 0 Forceful striking of skin with cupped hands 0 Vibration 0 Serves of vigorous quivering produced by hands that are placed flat against clients chest wall; done during exhalation 0 Postural drainage 0 Drainage by gravity of secretions from various lung segments
  23. 23. Measures That PromoteAdequate Respiratory Function0 6. Proper suctioning 0 A catheter – for 12-18 mmHg, tip of mouth to earlobe 5 meters suction 5-10 seconds, max is 15 seconds, wall suction 80-120 mmHg0 7. Avoid environmental pollutants = smoking
  24. 24. Measures That PromoteAdequate Respiratory Function0 8. Using inflation devices 0 Incentive spirometry – to enhance deep inspiration 0 Intermittent positive pressure breathing 0 To administer O2 at pressures higher than the atmospheric pressure0 9. Administration of supplemental O2 0 Nasal cannula
  25. 25. Nursing Implication0 Since oxygen is colorless, odorless, and tasteless, leakage can’t be detected0 Since oxygen is dry, gas mucus membrane invitation could happen
  26. 26. Nursing Planning, Intervention, and Evaluation in O2 Administration0 Assess s and sx of hypoxemia0 Check doctor’s orders0 Open source before insertion of device0 Regulated accurately0 Place a “No Smoking” sign0 Avoid use of oil, grease, and alcohol
  27. 27. Nursing Planning, Intervention, and Evaluation in O2 Administration0 Check of electrical device malfunction0 Avoid using materials that could generate static electricity0 Humidify O20 Provide good oro-nasal hygiene0 Lubricate with water soluble stuff0 Document

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