Chapter 21: 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

Anatomy 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) 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 Oxygenation Physical assessment Monitoring the client’s respiratory rate Observing breathing pattern and effort Checking chest symmetry Auscultating lung sounds Color of skin, mucous membranes, lips, nailbeds See box 21-1 page 461

Assessing Oxygenation (cont’d) Arterial blood gases assess: Oxygenation, ventilation, and acid base balance Partial pressure of oxygen dissolved in plasma Percentage of hemoglobin saturated with oxygen The pH of blood-Acidosis ph<7.35 Alkalosis ph>7.45

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

Promoting Oxygenation Positioning: Fowler’s position Breathing techniques Deep breathing Incentive spirometry Pursed-lip breathing Diaphragmatic breathing Nasal strips

Oxygen Therapy Oxygen sources Wall outlet Portable tanks Liquid oxygen unit Oxygen concentrator

Oxygen Therapy (cont’d) Equipment used in oxygen administration Flowmeter Oxygen analyzer Humidifier

Oxygen Therapy (cont’d) Common delivery devices (cont’d) Nasal cannula Masks Simple mask Partial rebreather mask Non-rebreather mask Venturi mask

Oxygen Therapy (cont’d) Common delivery devices (cont’d) Face tent Tracheosto my collar T-piece

Additional delivery devices Nasal catheter

Oxygen Therapy (cont’d) Additional delivery devices (cont’d) Oxygen tent CPAP mask Transtracheal oxygen

Oxygen hazards Fire potential- O2 does not burn but it does support combustion Oxygen toxicity- refers to lung damage that developed when oxygen concentrations of more than 50% are administered for longer than 48-72 hours. Once it develops, it’s difficult to reverse.

Question Which is a common delivery device for oxygen? a. Flowmeter b. Nasal cannula c. Oxygen analyzer d. Humidifier

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

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

General 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) 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