1. Chapter 21:
Oxygenation

2. 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

3. 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

4. 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

5. 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

6. 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

8. 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

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

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

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

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

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

14. Additional delivery devices
Nasal catheter

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

16. 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 hours. Once it develops, it’s difficult to reverse.

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

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

19. Related Oxygenation Techniques
Water-seal chest tube drainage
A technique for evacuating air or blood from the pleural cavity

20. Hyperbaric oxygen therapy
Delivery of 100% oxygen at 3 times the normal atmospheric pressure within an airtight chamber

21. 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

22. 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