1. Chapter 21
Oxygenation

3. 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

4. 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

5. 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

6. Assessing Oxygenation
Physical assessment
Monitoring the client’s respiratory rate
Observing breathing pattern and effort
Checking chest symmetry
Auscultating lung sounds

7. 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

8. Arterial Blood Gases

9. 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

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

12. Diaphragmatic Breathing

13. Oxygen Therapy Oxygen sources Wall outlet Portable tanks
Liquid oxygen unit
Oxygen concentrator
Equipment used in oxygen administration

14. Oxygen Therapy (cont’d)
Equipment used in oxygen administration
Flowmeter
Oxygen analyzer
Humidifier
Common delivery devices
Nasal cannula

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

16. Oxygen Therapy (cont’d)
Common delivery devices (cont’d)
Face tent
Tracheostomy collar
T-piece
Additional delivery devices
Nasal catheter

17. Comparison of Oxygen Delivery Devices
(Refer to Table 21-4 in the textbook.)

18. Oxygen Therapy (cont’d)
Additional delivery devices (cont’d)
Oxygen tent and CPAP mask
Transtracheal oxygen
Oxygen hazards
Fire potential
Oxygen toxicity

19. Administering Oxygen Safely

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

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

22. 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

23. Nursing Implications Nursing diagnoses: hypoxemia or hypoxia
Ineffective breathing pattern
Impaired gas exchange
Anxiety
Risk for injury (related to oxygen hazards)

24. Ineffective Breathing Pattern
(Refer to Nursing Care Plan 21-1in the textbook.)

25. 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

26. 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