Oxygenation PDF

Oxygenation Introduction: The main function of our respiratory system is to provide the body with a constant supply of oxygen and to remove carbon dioxide. To achieve these functions, muscles and structures of the thorax create the mechanical movement of air into and out of the lungs called ventilat...

Oxygenation Introduction: The main function of our respiratory system is to provide the body with a constant supply of oxygen and to remove carbon dioxide. To achieve these functions, muscles and structures of the thorax create the mechanical movement of air into and out of the lungs called ventilation. Gas exchange occurs at the alveolar level where blood is oxygenated and carbon dioxide is removed. Several respiratory conditions can affect a patient’s ability to maintain adequate ventilation and respiration, and there are several medications used to enhance a patient’s oxygenation status. Definition: Oxygen: Is the most essential of all basic survival needs. Without oxygen circulating in the bloodstream, a person will die in a matter of minutes. Oxygen is provided to the cells by maintaining an open airway and adequate circulation. Oxygenation: It is process refers to how well the cells, tissues, and organs of the body are supplied with oxygen through the respiratory system functions. 69 | P a g e Respiration is the physiological process of taking in oxygen from the environment during inhalation, while getting rid of carbon dioxide during exhalation. It involves both ventilation and oxygenation. Physiology of respiration: While ventilation brings air into the lungs, it is oxygenation that helps ensure that the cells and body tissues receive enough oxygen molecules. The gaseous exchange occurs by diffusion in the alveoli. It depends on essentially three factors: o The integrity of the airway system to transport air to and from the lungs. o A properly functioning alveolar system in the lungs to oxygenate venous blood and to remove carbon dioxide from the blood. Mechanism of ventilation: 1. Inhalation (Inspiration) Expansion of the chest cavity and lungs creates negative pressure inside the lungs, causing air to be drawn in through the nose or mouth and airways. 2. Exhalation (Expiration)When the diaphragm and intercostal muscles relax, exhalation allows the chest and lungs to return to their normal resting size. 70 | P a g e Process of Oxygenation ▪ Ventilation: The process of moving gases into and out of the lungs. ▪ Perfusion: The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs. ▪ Diffusion: Exchange of respiratory gases in the alveoli and capillaries. Exchange of respiratory gases: refers to, the oxygenation of blood and elimination of carbon dioxide in the lungs. 3. External Respiration Alveolar capillary gas exchange (or external respiration) occurs in the alveoli of the lungs. 4. Internal Respiration Capillary tissue gas exchange (or internal respiration) occurs in body organs and tissues. Factors Affecting Oxygenation Physiological factors (Increased metabolic rate). Disease process (Anemia, Hypovolemia, Fever, Obesity & Dehydration and hemorrhage). Decreased inspired oxygen concentration Environmental factors (High altitudes &occupational pollutants). Factors affecting chest wall movement (Trauma) Pregnancy Musculoskeletal abnormalities Medications Lifestyle Risk Factors (Activity and exercise, Stress, smoking & substance abuse). 71 | P a g e Common Respiratory Alterations ▪ Hyperventilation: ventilation in excess of that required; rate and depth of respirations increase. ▪ Hypoventilation: alveolar ventilation inadequate to meet the body’s oxygen demand; respiratory rate and depth is low ▪ Hypoxia: Inadequate tissue oxygenation at the cellular level, late sign cyanosis ▪ Hypoxemia: Inadequate blood oxygenation. ▪ Altered breathing patterns 1. Tachypnea (rapid rate) 2. Bradypnea (abnormally slow rate) 3. Apnea (cessation of breathing) 4. Dyspnea & Orthopnea ▪ Obstructed or partially obstructed airway: As a result of the presence of foreign body, or accumulation of mucus or inflammatory exudates. Nursing Interventions: Airway Management: ▪ Administer humidified air or oxygen immediately ▪ Regulate fluid intake ▪ Monitor respiratory and oxygenation status ▪ Administer drug therapy (bronchodilators, corticosteroids) ▪ Auscultate lung sounds before and after treatments Cough Enhancement ▪ Positioning for chest expansion ▪ Deep breathing, hold for 2 seconds, and cough 2-3 times. 72 | P a g e Respiratory Monitoring: Rate, rhythm, depth, and effort (overall patterns) Monitor for increased restlessness, anxiety, and air hunger Note changes in oxygen saturation (SaO2), arterial blood gases (ABG) values. Anxiety Reduction Calming & reassuring attitudes Stay with patient Encourage slow breathing (pursed lips) Teaching: ▪ Identify level of knowledge disease process & prescribed Medication ▪ Instruct on measure to prevent/minimize side effects of treatment Evaluate patient’s ability to self-administer medications ▪ Instruct patient on purpose, action, dosage, and duration of each medication ▪ Include family and significant others 73 | P a g e