2. Oxygenation
0 Oxygenation is a basic human need
0 Breathing is synonymous to life, thus, oxygen is
required to sustain life
0 2 body systems that supply the body’s oxygen
demands
0 Cardiovascular system
0 Respiratory system

3. Respiratory System
0 The lung transfers O2 from the atmosphere into the
alveoli, where the O2 is exchanged for CO2
0 The alveoli transfers O2 and CO2 to and from the blood
through the alveolar membrane

4. Pulse Oximetry
0 Noninvasive
0 Estimates arterial blood oxygen susturation (SpO2)
0 Normal SpO2 95-100%
0 < 70% - life threatening
0 Detects hypoxemia (low oxygen; more in blood)
before clinical
0 Sensor, photodetector, pulse oximeter unit

5. Pulse Oximetry
0 Factors that affect accuracy include
0 Hemoglobin level
0 Circulation
0 Activity
0 Carbon monoxide poisoning

6. Respiration
0 Processes
0 Ventilation
0 Diffusion
0 Perfusion

7. Ventilation
0 Factors influencing ventilation
0 Adequate atmosphere oxygen
0 Clear air passages
0 Adequate pulmonary compliance and recoil
0 Regulation of respiration

8. Diffusion
0 Factors influencing diffusion of gasses
0 Thickness of membrane
0 Surface area of the membrane
0 Diffusion coefficient of gasses
0 Pressure gradient on each side of the membrane

9. Perfusion
0 Factors affecting oxygen transport from lungs to the
tissues
0 Cardiac output
0 Number of erythrocytes
0 Exercise
0 Blood hematocrit

10. Factors Affecting Oxygenation
0 Environment (altitude, heat, cold, air pollution)
0 Exercise
0 Emotions (fear, anxiety, anger)
0 Lifestyles (smoking, occupations, sedentary life, etc)
0 Health status (anemia [low red blood cells]
respiratory)
Narcotics (morphine, demorol, etc)

11. 3 Major Alterations in
Respiratory Functions
0 1. Hypoxia
0 Respiratory insufficiency
0 Acapnea (absence of CO2 in blood)
0 Hypocarbia
0 Depressed level of CO2 in the blood
0 Hyperpnea (rapid breathing)
0 Hypopnea (slow breathing)

12. Signs of Hypoxia
0 Early/ acute signs
0 Restlessness
0 Increased pulse rate
0 Increased rate and depth of respiration
0 Increase in systolic blood pressures

13. Signs of Hypoxia
0 Late/chronic signs
0 Decreased pulse rate
0 Decreased systolic blood pressure
0 Dyspnea
0 Fatigue and lethargy
0 Cough
0 Hemoptysis
0 Clubbing of fingers

14. 3 Major Alterations in
Respiratory Functions
0 2. Altered breathing patterns
0 Rate
0 Volume (hypo or hyper)
0 Rhythm (Cheyne Stokes, Kussmaul’s, Apneustic, and
Biat’s)
0 Relative case of effort respiration (dyspnea and
orropnea)

15. 3 Major Alterations in
Respiratory Functions
0 3. Obstructive or particularly obstructive airways
0 Upper airway, obstruction
0 nose, pharynx, larynx, trachea

16. NANDA Nursing Diagnosis
Related to Oxygenation
0 1. Ineffective airway clearance
0 Refers to inability of the individual to clear secretions or
obstruction from the respiratory tract to maintain
airway patency
0 Tracheobrachial infections
0 Obstructions, secretions

17. NANDA Nursing Diagnosis
Related to Oxygenation
0 2. Ineffective breathing pattern
0 Refers to and individual’s inhalation or exhalation
pattern that inhibits adequate ventilation
0 Neuromuscular
0 Pain, anxiety
0 Decreased energy and fatigue
0 Inflammatory process

18. NANDA Nursing Diagnosis
Related to Oxygenation
0 3. Decreased cardiac output
0 State in which the blood pumped by the heart is
sufficiently reduced that it is inadequate to meet the
needs of the body
0 Structural alteration
0 Ventricular – septal rupture, valvular disease

19. NANDA Nursing Diagnosis
Related to Oxygenation
0 4. Impaired gas exchange
0 State in which there is an imbalance between O2 and
CO2 elimination at the alveolar capillary membrane gas
exchange area
0 Altered O2 supply
0 Altered blood

20. NANDA Nursing Diagnosis
Related to Oxygenation
0 5. Altered tissue perfusion
0 State in which an individual experiences a decrease in
nutrition and oxygenation at the cellular level because
of a deficit in capillary blood supply
0 Interrupted venous or arterial flow
0 Hypo/hyper volemia

21. Measures That Promote
Adequate Respiratory Function
0 1. Ensure a patent airway
0 To promote gaseous exchange between client and
environment
0 Check for obstructions
0 Foreign objects, mucus
0 2. Positioning
0 To allow maximum chest expansion
0 Fowler’s position
0 Encourage frequent changes

22. Measures That Promote
Adequate Respiratory Function
0 3. Deep breathing and coughing exercises
0 To promote lung expansion and loosen secretions
0 E.g. abdominal breathing (diaphragmatic and pursed lip)
0 4. Adequate hydration
0 Maintain moisture of the respiratory mucus membrane
0 Use of humidifiers/ nebulizers
0 Steam/ aerosol/ medimist

23. Measures That Promote
Adequate Respiratory Function
0 5. Chest physiotherapy
0 Percussion
0 Forceful striking of skin with cupped hands
0 Vibration
0 Serves of vigorous quivering produced by hands that are
placed flat against clients chest wall; done during
exhalation
0 Postural drainage
0 Drainage by gravity of secretions from various lung
segments

24. Measures That Promote
Adequate Respiratory Function
0 6. Proper suctioning
0 A catheter – for 12-18 mmHg, tip of mouth to earlobe 5
meters suction 5-10 seconds, max is 15 seconds, wall
suction 80-120 mmHg
0 7. Avoid environmental pollutants = smoking

25. Measures That Promote
Adequate Respiratory Function
0 8. Using inflation devices
0 Incentive spirometry – to enhance deep inspiration
0 Intermittent positive pressure breathing
0 To administer O2 at pressures higher than the atmospheric
pressure
0 9. Administration of supplemental O2
0 Nasal cannula

26. Nursing Implication
0 Since oxygen is colorless, odorless, and tasteless,
leakage can’t be detected
0 Since oxygen is dry, gas mucus membrane invitation
could happen

27. Nursing Planning, Intervention,
and Evaluation in O2
Administration
0 Assess s and sx of hypoxemia
0 Check doctor’s orders
0 Open source before insertion of device
0 Regulated accurately
0 Place a “No Smoking” sign
0 Avoid use of oil, grease, and alcohol

28. Nursing Planning, Intervention,
and Evaluation in O2
Administration
0 Check of electrical device malfunction
0 Avoid using materials that could generate static
electricity
0 Humidify O2
0 Provide good oro-nasal hygiene
0 Lubricate with water soluble stuff
0 Document