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Enhancing Oxygenation in Clinical Practice

Learn about assessing oxygenation, promoting effective breathing techniques, understanding arterial blood gases, and the use of oxygen therapy. Gain insights into gerontologic considerations and nursing implications for respiratory care.

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Enhancing Oxygenation in Clinical Practice

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  1. Chapter 21 Oxygenation

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

  3. Arterial blood gases measure: • Partial pressure of oxygen dissolved in plasma • Percentage of hemoglobin saturated with oxygen • The pH of blood

  4. Arterial Blood Gases

  5. Pulse oximetry • Composed of a sensor and a microprocessor • Noninvasive, transcutaneous technique for periodically or continuously monitoring the oxygen saturation of blood

  6. Promoting Oxygenation 1-Positioning: Fowler’s position

  7. 2-Breathing techniques • Deep breathing • Incentive spirometry: a method of encouraging voluntary deep breathing by providing visual feedback about inspiratory volume. The patient inhales until a preset volume is reached, then sustains the inspiratory volume by holding his or her breath for 3 to 5 seconds. It reduces the risk of atelectasis and pulmonary consolidation.

  8. Pursed-lip breathing

  9. Diaphragmatic breathing

  10. Diaphragmatic Breathing

  11. -Nasal strips: gently open your nasal passages helping you to breathe better by providing temporary relief from nasal congestion and stuffiness which can be caused by colds and allergies. Each drug-free nasal strip consists of flexible “spring-like” bands that when placed correctly across the nose, gently opens the nasal passages to make breathing easier.

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

  13. Equipment used in oxygen administration • Flowmeter

  14. Oxygen analyzer

  15. -Humidifier

  16. Common delivery devices • Nasal cannula

  17. Masks • Simple mask • Partial rebreather mask • Non-rebreather mask • Venturi mask

  18. Face tent

  19. Tracheostomy collar

  20. T-piece

  21. Additional delivery devices • Nasal catheter

  22. Oxygen tent and CPAP mask (continuous positive airway pressure): Very helpful for patients with sleep apnea.

  23. Transtracheal oxygen • Oxygen hazards • Fire potential • Oxygen toxicity

  24. 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

  25. 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

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

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

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