PROMOTING OXYGENATION

DEFINITION

OXYGENATION – the process that supplies oxygen to the blood and cells

- without adequate oxygen, cells

cannot survive

3 PHASES OF ADEQUATE RESPIRATORY FUNCTION

1. PULMONARY VENTILATION- inhalation and exhalation of air between the atmosphere and the alveoli of the lungs

1. PERFUSION- Diffusion or movement of oxygen and carbon dioxide between the alveoli and the pulmonary capillaries

3 PHASES OF ADEQUATE RESPIRATORY FUNCTION

1. Gas Exchange- transport of oxygen and carbon dioxide via the blood to and from the cells

3 PHASES OF ADEQUATE RESPIRATORY FUNCTION

Most common signs of Hypoxia

1. Tachycardia2. Restlessness3. Cyanosis4. Increased blood pressure followed

by decreased blood pressure

1. Dyspnea2. Flaring Nostrils3. Substernal /

intercostal retractions

Most common signs of Hypoxia

Coughing and Deep Breathing Exercises

COUGHING – natural defense mechanism

DEEP BREATHING – maximizing normal respiratory volume

Voluntary controlled coughing clears the airways before secretions accumulate

Voluntary deep breathing exercises improve ventilation

Coughing and Deep Breathing Exercises

DEEP BREATHING EXERCISES

•Taught to those at risk for respiratory problems, such as surgical clients

•Pursed-lip breathing is taught to clients with alveolar distention to increase effective exhalation and decrease the workload of breathing

Pursed-Lip Breathing

Purposes of Coughing and Deep Breathing

1. To loosen secretions2. To promote full lung

expansion1. To clear airways of

pulmonary secretions1. To encourage a more

effective cough1. To improve pulmonary

ventilation

Procedure in Coughing Exercises

1. Assemble equipments: facial tissues, pillow, stethoscope

2. Explain procedure and provide privacy

1. Assist to a High-fowler’s position or upright position

1. If with abdominal incision, support incision with pillow firmly or with palms

Procedure in Coughing Exercises

1. Instruct patient to take several deep breaths and then to inhale deeply, hold it for a second, contract abdominal muscles, and cough into a tissue

1. Encourage patient to cough frequently until airway is cleared

Procedure in Coughing Exercises

Procedure in Deep Breathing Exercises

1. Explain procedure and provide patient’s privacy

2. Help patient to an upright position (on bed or chair), with both feet on the floor.

Definition

• The process of providing or combining or treating with oxygen

GOALS OF OXYGENATION

1. Improve tissue oxygenation2. Decrease work of breathing in

dyspneic patients3. Decrease work of the heart in patients with cardiac disease

OXYGEN SAFETY

• Prominently display a “NO SMOKING” sign on the patient’s door

• Inspect all electrical equipment in the immediate vicinity of the patient

• Do not allow the patient to

use an electric razor

OXYGEN SAFETY

• Avoid using woolen blankets• Take special precautions with

patients in oxygen tent (do not comb hair or allow electric call bells to be operated in a closed tent)

OXYGEN STORAGE

• Piped-in System• Tank System

– Large– Small

Piped-In System

OXYGEN THERAPY

Oxygen tank

humidifier

Oxygen mask

Flow meter

oxygen regulator

FLOW METER• A device that attaches to the

oxygen outlet to regulate the amount and pressure of oxygen delivered

humidifier

Mercury ball flow meter

Oxygen regulator

TYPES OF FLOW METERS

• Mercury Ball

• Gauge Type

HUMIDIFIER

• Containers with sterile water which are attached to the administration device

METHODS OF ADMINISTRATION

• Nasal Cannula• Nasal Catheter• Oxygen Mask

Standard maskNon-rebreathing maskVenturi mask

• Oxygen Tent• Oxygen Hood• Self-inflating Breathing Bag and Mask

NASAL CANNULA

• aka nasal prongs• Most common method • May administer 1-6 liters per

minute• Provides 24% - 44% oxygen in the

inspired air• Most commonly used in low flow rates of

2-3 liters/minute

NASAL CANNULA

• Procedure on pages 573 – 575 of Taylor’s Clinical Nursing Skills

NASAL CATHETER

• Plastic or rubber catheter with a small lumen

• Used infrequently(irritates pts. nostril)

• Tip of the catheter should be visible at a position near the uvula

• Should be transferred to the other nostril every 8 hours

OXYGEN MASK

• Method of choice in emergency situations or when a relatively high concentration of oxygen is needed promptly

• Gives a high-flow rate(6-10 liters/minute)(35% - 60%)

• Procedure on pages 576 – 580 of Taylor’s Clinical Nursing Skills

STANDARD MASK

• Has side vents• Provides a reservoir over

the face into which oxygen flows

• most common midrange O2 device• Not usually desirable for COPD pts

because of potential for excessive oxygenation

VENTURI MASK

• Delivers 4-10 liters/min (24% - 55%)

• Precise delivery system• Noisy

NON-REBREATHING MASK

• Has a bag attached to the bottom• Used for critically ill pts• Delivers 6-15 liters/min (60% -

100%)

OXYGEN TENT

• Used in children who will not leave a face mask or nasal cannula in place

• Made of a transparent plastic canopy that is suspended from a frame, with an electric cooling unit.

OXYGEN HOOD

• Deliver oxygen to infants at rates approaching 100%

• Placed over the infant’s head• Made up of hard plastic or vinyl

with a metal frame

SELF INFLATING BREATHING BAG AND MASK

• Often called the Ambu Bag• Provides artificial

ventilation to the person who is in respiratory arrest or is dependent on a ventilator for breathing

• Can be used for rescue breathing or CPR