OXYGENATION
Fundamentals of Nursing II
NURS(202)
Spring 2021
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Oxygenation
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Learning Outcomes
Review the structure & function of the respiratory system
and the process of breathing.
Identify factors influencing respiratory function.
Identify common manifestations of impaired respiratory
function.
Describe nursing measures to promote respiratory function
and oxygenation.
Explain the use of therapeutic measures e.g. medications,
O2 therapy, suctioning, and chest tubes to promote
respiratory function.
State outcome criteria for evaluating client responses to
measures that promote adequate oxygenation.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Function of the Respiratory System
• The function of the respiratory system is gas
exchange
• Oxygen from inspired air diffuses from alveoli
in the lung into the blood in the pulmonary
capillaries
• Carbon dioxide produced during cell
metabolism diffuses from the blood into the
alveoli and is exhaled.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
The Respiratory System
A
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb https://www.youtube.com/watch?v=wP6z2fBqPzY
Copyright 2008 by Pearson Education, Inc.
Process of Breathing
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Oxygen Transport
• Transported from the lungs to the tissues
• 97% of oxygen combines with hemoglobin in red
blood cells and carried to tissues as
oxyhemoglobin
• Remaining oxygen is dissolved and transported
in plasma and cells
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Factors that Influence
Respiratory Function
• Age
• Environment
• Lifestyle
• Health status
• Medications
• Stress
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Common Manifestations of
Impaired Respiratory Function
• Hypoxia
• Altered breathing patterns
• Obstructed or partially obstructed airway
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Hypoxia
• Condition of insufficient oxygen in body tissue
• Causes: impaired ventilation, diffusion or O2 transportation.
• Acute versus chronic hypoxia.
• Manifestations:
• Rapid pulse
• Rapid, shallow respirations and dyspnea
• Increased restlessness or lightheadedness
• Flaring of nares
• Substernal or intercostal retractions
• Cyanosis
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Altered Breathing
Patterns
• Tachypnea (abnormally rapid rate)
• Bradypnea (abnormally slow rate)
• Apnea (cessation of breathing)
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Alterations in Ease of
Breathing
• Orthopnea:
➢ Inability to breath except in an
upright or standing position.
• Dyspnea:
➢ Difficult or uncomfortable
breathing.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Obstructed or Partially
Obstructed Airway
• Causes: foreign object, secretions, tumor
• Partial: indicated by low-pitched snoring during
inhalation
• Complete: is indicated by extreme inspiratory
effort with no chest movement.
• Other signs: strider, restlessness, dyspnea,
sternal and intercostal retraction.
• Priority management: patent airway.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Nursing Measures to Promote
Respiratory Function
• Ensure a patent airway
• Positioning
• Encouraging deep breathing,
coughing
• Ensuring adequate hydration to
maintain moisture of the
respiratory mucous membranes.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Therapeutic Measures to
Promote Respiratory Function
• Medications
• Incentive spirometry
• Chest physio-therapy
• Postural drainage
• Oxygen therapy
• Artificial airways
• Airway suctioning
• Chest tubes
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Incentive Spirometry
A B
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Chest PT
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Oxygen Therapy
Remember: Oxygen Is A Drug
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Oxygen Therapy
Nasal Cannula Simple Face Mask Partial Rebreather
•Most common •Delivers 40-60% Mask
•Delivers 24%-45% •Flow rate 5-8 L/M •Delivers 60-90%
•Flow rate 2-6 L/M •Flow rate 6-10 L/M
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Oxygen Therapy
Nonrebreather Mask Venturi Mask
•Delivers 95-100% •Delivery varied from 24-40-50
•Flow rate of 10-15 L/M •Flow rate of 4-10 L/M
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb •Color coded jet adaptors
Copyright 2008 by Pearson Education, Inc.
Incentive Spirometry Video
Click here to view a video on incentive spirometry.
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Copyright 2008 by Pearson Education, Inc.
Nonrebreather Mask Video
Click here to view a video on nonbreather masks.
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Copyright 2008 by Pearson Education, Inc.
Artificial Airways
Oropharyngeal Nasopharyngeal
Airway Airway
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
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Tracheostomy Tube
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Chest Drainage System
• Pneumothorax & hemothorax places pressure on
lungs tissues & interfere with lung expansion.
• Chest tube insertion into the plural cavity
restore negative pressure.
• Nursing care includes:
• Monitor & maintain patency of drainage system.
• Monitor vital signs
• Observe dressing site.
• Frequent repositioning of client.
• Keep the water-seal unit below chest level
upright.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Indications of Chest
Drainage System
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Desired Outcomes for patient
with respiratory disorders
• Maintain a patent airway
• Improve comfort and ease of breathing
• Maintain or improve pulmonary
ventilation and oxygenation
• Improve ability to participate in
physical activities
• Prevent risks associated with
oxygenation problems
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Evaluation
• Collect data to evaluate the effectiveness of
interventions
• If outcomes not achieved, explore the
reasons before modifying the care plan
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Resources
• Audio Glossary
• American Lung Association Fact Sheet: Oxygen Therapy
Describes oxygen, how it's used by the body, and ways of
delivering supplemental oxygen
• Postgraduate Medicine: Long-term Oxygen Therapy for
COPD
An article about improving longevity and quality of life in
hypoxemic clients through long-term oxygen therapy
• Loyola University Chicago Stritch School of Medicine
Wonderful site for a screening and physical exam of the
lungs and respiratory system
• The R.A.L.E. Repository
Excellent site to learn about lung sounds
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
Resources
• American Lung Association
Wonderful site for information on lungs and lung diseases
• Asthma and Allergy Foundation of America
Site helps improve the quality of life for clients with asthmas and
allergies through education, research, and advocacy
• Canadian Lung Association
Wonderful site for information on lungs and lung diseases,
especially COPD (Chronic Obstructive Pulmonary Disease)
• Lung Cancer Online
Educational site for lung cancer. Includes topics including general
information, treatment options, symptoms, side effects,
complications, tests, procedures, and other Web sites. Also gives
information for living and coping with lung cancer.
• Australian Lung Foundation
Promotes better lung health and coping for people with chronic
lung diseases. Wonderful site for general information about the
lungs and various lung diseases.
Copyright 2008 by Pearson Education, Inc.
Kozier & Erb's Fundamentals of Nursing, 8e
Berman, Snyder, Kozier, Erb
Copyright 2008 by Pearson Education, Inc.
