Ppt chapter 21

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 21

Oxygenation


Oxygenation Oxygenation

• Oxygen: measures approximately 21% in the Earth’s atmosphere

• Each cell of the human body uses oxygen to metabolize nutrients and produce energy

• Without oxygen, cell death occurs rapidly


QuestionQuestion

•Is the following statement true or false?

Expiration creates more chest space, causing the pressure within the lungs to fall below that in the atmosphere.


AnswerAnswer

False.

Inhalation creates more chest space, causing the pressure within the lungs to fall below that in the atmosphere.


Anatomy and Physiology of BreathingAnatomy and Physiology of Breathing

• Inspiration and expiration

• Ventilation: movement of air in and out of lungs; facilitates respiration

• Respiration: exchange of oxygen and carbon dioxide


Anatomy and Physiology of Breathing(cont’d)

Anatomy and Physiology of Breathing(cont’d)

• External and internal respiration

– External respiration takes place at most distal point in airway: between the alveolar-capillary membranes

– Internal respiration occurs at the cellular level between hemoglobin and body cells


Assessing OxygenationAssessing Oxygenation

• Physical assessment

– Monitoring the client’s respiratory rate

– Observing breathing pattern and effort

– Checking chest symmetry

– Auscultating lung sounds


Assessing Oxygenation (cont’d)Assessing Oxygenation (cont’d)

• Arterial blood gases measure:

– Partial pressure of oxygen dissolved in plasma

– Percentage of hemoglobin saturated with oxygen

– The pH of blood


Arterial Blood Gases Arterial Blood Gases


Assessing Oxygenation (cont’d)Assessing Oxygenation (cont’d)

• Pulse oximetry

– Composed of a sensor and a microprocessor

– Noninvasive, transcutaneous technique for periodically or continuously monitoring the oxygen saturation of blood


QuestionQuestion

•Which of the following is used for monitoring the oxygen saturation of blood?

a. Arterial blood gases

b. Pulse oximetry

c. Incentive spirometry

d. Oxygen analyzer


AnswerAnswer

b. Pulse oximetry

Pulse oximetry is a technique for periodically or continuously monitoring the oxygen saturation of blood. Arterial blood gases monitor the pH of blood. Incentive spirometry is a technique for deep breathing using a calibrated device. Oxygen analyzer is a device that measures the percentage of delivered oxygen to the client.


Promoting Oxygenation Promoting Oxygenation

• Positioning: Fowler’s position

• Breathing techniques

– Deep breathing

o Incentive spirometry

– Pursed-lip breathing

– Diaphragmatic breathing

– Nasal strips


Diaphragmatic BreathingDiaphragmatic Breathing


Oxygen TherapyOxygen Therapy

• Oxygen sources

– Wall outlet

– Portable tanks

– Liquid oxygen unit

– Oxygen concentrator

• Equipment used in oxygen administration


Oxygen Therapy (cont’d)Oxygen Therapy (cont’d)

• Equipment used in oxygen administration

– Flowmeter

– Oxygen analyzer

– Humidifier

• Common delivery devices

– Nasal cannula



• Common delivery devices (cont’d)

– Masks

o Simple mask

o Partial rebreather mask

o Non-rebreather mask

o Venturi mask



• Common delivery devices (cont’d)

– Face tent

– Tracheostomy collar

– T-piece

• Additional delivery devices

– Nasal catheter


Comparison of Oxygen Delivery Devices

Comparison of Oxygen Delivery Devices

(Refer to Table 21-4 in the textbook.)



• Additional delivery devices (cont’d)

– Oxygen tent and CPAP mask

– Transtracheal oxygen

• Oxygen hazards

– Fire potential

– Oxygen toxicity


Administering Oxygen SafelyAdministering Oxygen Safely


QuestionQuestion

•Which of the following is a common delivery device for oxygen?

a. Flowmeter

b. Nasal cannula

c. Oxygen analyzer

d. Humidifier


AnswerAnswer

b. Nasal cannula

Nasal cannula is a common delivery device. Flowmeter, oxygen analyzer, and humidifier are equipment used in oxygen administration.


Related Oxygenation Techniques Related Oxygenation Techniques

• Water-seal chest tube drainage

– A technique for evacuating air or blood from the pleural cavity

• Hyperbaric oxygen therapy

– Delivery of 100% oxygen at 3 times the normal atmospheric pressure within an airtight chamber


Nursing ImplicationsNursing Implications

• Nursing diagnoses: hypoxemia or hypoxia

– Ineffective breathing pattern

– Impaired gas exchange

– Anxiety

– Risk for injury (related to oxygen hazards)


Ineffective Breathing PatternIneffective Breathing Pattern

(Refer to Nursing Care Plan 21-1in the textbook.)


General Gerontologic ConsiderationsGeneral Gerontologic Considerations

• Reduced gas exchange and efficiency in ventilation; major age-related changes occur in the respiratory system

• Respiratory muscles become weaker and the chest wall becomes stiffer as a result of calcification of the intercostal cartilage


General Gerontologic Considerations (cont’d)

General Gerontologic Considerations (cont’d)

• Diminished cough and gag reflexes, increased use of accessory muscles for breathing, increased mouth breathing, snoring

• Inactive, debilitated, or chronically ill clients or smokers are at a higher risk for respiratory infections and compromised respiratory function

Ppt chapter 21

Technology