Oxygenation

OXYGENATION
NURSING INSTRUCTOR: SIR JERRY ZAHID
8/24/2021 GUKFREEN COLLEGE OF NURSING 1

OBJECTIVE
AFTERTHIS PRESENTATION THE STUDENTS WILL BE ABLETO:
■ Define oxygenation
■ Identify the factors affecting oxygenation
■ Elaborate the common manifestation of altered respiratory and
cardiac function

DEFINITION
“Oxygenation is the delivery of oxygen to the body tissues and cells.”
Physiology of oxygenation:The delivery of oxygen to body cells is a
process that depends on the interplay of the pulmonary, hematologic
and cardiovascular systems.
 Specifically, the process involved include: ventilation, alveolar gas
exchange, oxygen transport and delivery and cellular respiration

FACTORS AFFECTING OXYGENATION
■ Adequate oxygenation is influenced by many factors including:
age, environmental and life style factors and disease process.
1. Age: older adults may exhibit a barrel chest and require increased
effort to expand the lungs.
 Older adults are also more susceptible to respiratory infections
because of decreased activity of cilia which normally are effective
defense mechanism .

2. Environmental and lifestyle factors: Environmental and lifestyle
factors can significantly affect clients oxygenation status.
 Clients who are exposed to dust, animal dander, chemicals in the
home or workplace are at increased risk for alteration in oxygen.
 Individuals who experience significant physical or emotional stress or
who are obese or underweight are also subject to changes in
oxygenation status.
 Smokers and second hand smokers are also affected.

3. Disease process: Oxygenation alterations can often be traced
to alteration in alveolar gas exchange, oxygen uptake or
circulation.
 Diseases that may affect oxygenation include: obstructive
pulmonary disease, atherosclerosis heart failure, anaemia.

MANIFESTATIONOF ALTERED
RESPIRATORYAND CARDIAC
FUNCTION
■ When oxygen delivery is inadequate to meet metabolic needs of the
body, various responses to this deficit can be expected and these
include:
1. Increased oxygen extraction.
2. Anaerobic metabolism.

3.Tissue ischemia and cell death.
4. Signs and symptoms of hypoxia: Early signs are restlessness , dizziness,
increased pulse rate.
5. If hypoxia remains untreated, the respiratory rate may decline and
changes in the level of consciousness may progress to comma.
6. Perfusion deficits resulting in poor circulation can obviously be noted in
the skin cyanosis ( bluish discoloration of the skin) which can also easily
be seen in the tongue, soft palate and conjunctiva of the eye( these
indicate hypoxemia).

7. Cyanosis of extremities, nail beds and earlobes is often as a result of
vasoconstriction and stagnant(motionless or static) blood flow.
8. Clubbing of the fingers which manifests as a flattened angle of the
nail bed and rounding of fingertips is a sign of chronic hypoxia.

LIFE-SPAN RELATED CHANGES AND
PROBLEMS IN CVS
■ Left ventricular wall thickness increased.
■ Reduction in left ventricular filling rate.
■ End diastolic volume

■ Myocardial contractility lessen.
■ End diastolic volume elevated.
■ Ejection fraction decreased.
■ Arterial wall thickness increased.
■ Systolic blood pressure increased.
■ Diastolic blood pressure increased.
■ Orthostatic tolerance.
■ Arterial and venous dilation
minimal .
■ Vasoconstriction

CHANGES AND PROBLEMS IN RESPIRATORY SYSTEM
■ Chest wall stiffness increased.
■ Reduced elastic recoil.
■ Reduced alveolar capillary surface
area.
■ Reduced forced expiratory flow.
■ Reduced total residual volume.
■ Reduced forced vital capacity.
■ Increased pulmonary vascular
resistance
■ High expiratory flow limitation
■ High minute ventilation
■ Work of breathing increased.
■ Increased Pulmonary artery
pressure

NURSING MEASURESTO MAINTAIN PATENT
AIRWAY
■ Assist patient in performing deep breathing and coughing exercises.
Instruct patient in the following:
■ Optimal positioning (sitting position).
■ Use of pillow or hand splints when coughing.
■ Use of abdominal muscles for more forceful cough.
■ Use of Incentive Spirometer.
■ Importance of ambulation and frequent position changes.

■ If cough is ineffective use Suctioning as needed to remove sputum
and mucus plugs.
■ Encourage adequate intake of fluids to prevent dehydration.
■ Administer medications (e.g., antibiotics, mucolytic agents,
bronchodilators, expectorants) as ordered.
■ Consult respiratory therapist for chest physiotherapy.
■ Provide Steam Inhalation to clear the secretions.
■ If the obstruction is not resolved insert airway.

■ Most common invasive air ways are
a) Oropharyngeal airway.
b) Nasopharyngeal airway
c) Tracheal intubation.
Surgical management:
Tracheotomy is a surgically created opening from the skin of
the neck down to the trachea.

RESPIRATORY EMERGENCIES
■ A broad range of different respiratory emergencies is covered,
from aspiration pneumonia, pneumothorax, pulmonary
embolism, right heart failure and haematothorax to acute
exacerbations of diseases such as asthma and chronic obstructive
pulmonary disease.

CARDIAC EMERGENCIES
■ Today, acute ST elevation myocardial infarction, cardiogenic
shock, and out-of-hospital cardiac arrest are the most life-
threatening cardiovascular emergencies. Acute coronary
syndrome, pulmonary embolism, acute infective endocarditis,
arrhythmia, cardiogenic shock, acute aortic dissection, and so
forth are medical emergencies with high mortality rates.

METHODS OF INFECTION CONTROL
Standard Precautions
■ Hand hygiene.
■ Use of personal protective equipment (e.g., gloves, masks, eyewear).
■ Respiratory hygiene / cough etiquette.
■ Sharps safety (engineering and work practice controls).
■ Safe injection practices (i.e., aseptic technique for parenteral
medications).
■ Sterile instruments and devices.

DIFFERENCE BETWEEN MEDICAL &
SURGICALASEPSIS

Oxygenation

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