Oxygenation
by
Johann Gurnell
Functions of the
Respiratory System
• Ventilation
• Respiration
• Perfusion
The Organs of the
Respiratory Tract
Factors Related to the
Normal Functioning of the
Respiratory System
• The integrity of the airway system to transport air to and
from lungs
• A properly functioning alveolar system in the lungs to
oxygenate venous blood and remove carbon dioxide
• A properly functioning cardiovascular and hematologic
system to carry nutrients and wastes to and from body
cells
Factors Affecting
Respiratory Functioning
• Level of health
• Developmental level
• Medications
• Life style
• Environment
• Psychological health
Using a Pulse Oximeter
• Purpose
– Measure the oxyhemoglobin saturation of blood
• Method
– A sensor or probe, uses a beam of red and infrared
light which travels through tissue and blood vessels
– The oximeter calculates the amount of light
absorbed by blood
– Oxygen saturation is determined by the amount of
each light absorbed
Uses for Pulse Oximetry
• Monitoring patients receiving oxygen therapy
• Titrating oxygen therapy
• Monitoring those at risk for hypoxia
• Monitoring postoperative patients
Purposes of Incentive
Spirometry
• Provides visual reinforcement for deep breathing by the
patient
• Assists the patient to breathe slowly and deeply
• Helps the patient to sustain maximal inspiration, while
providing immediate positive reinforcement
• Encourages the patient to maximize lung inhalation to
prevent or reduce atelectasis
• Supports optimal gas exchange
• Helps patient to clear and expectorate secretions
Incentive Spirometry
Oxygen Delivery Systems
• Nasal cannula
• Simple mask
• Partial rebreather mask
• Nonrebreather mask
• Venturi mask
Administering Oxygen by
Nasal
Cannula
• Most commonly
used oxygen
delivery device
• Disposable device with two protruding prongs inserted
into the nostrils
• Connects to an oxygen source with a flowmeter and
many times a humidifier
• Delivers from 1 L per minute to 6 L per minute of oxygen
• Does not impede eating or speaking; easily used at
home
• Can be easily dislodged and cause dryness of the nasal
mucosa
Applying Cannula to
Nares
Criteria for
Documentation of Use of
Oxygen Mask
• Type of mask used
• Amount of oxygen used
• Oxygen saturation level
• Lung sounds
• Rate/pattern of respirations
• Pre- and post-intervention assessment
Simple Mask
Non-rebreather
Venturi Mask
Placing Oxygen Hood Over
Baby
Using an Oxygen Tent
• Advantages
– Option for children who will not leave a face mask or
nasal cannula in place
– Gives the patient freedom to move in bed or crib
while humidified oxygen is being delivered
• Disadvantages
– Hard to keep closed due to contact with parents
– Difficult to maintain a consistent level of oxygen and
deliver oxygen at a higher rate than 30% to 50%
– Child’s clothing must be assessed for dampness
Suctioning the
Nasopharyngeal and
Oropharyngeal Airways
• Maintains a patent airway
• Removes saliva, pulmonary secretions, blood, vomitus,
or foreign material from the pharynx
• Helps a patient who cannot successfully clear his airway
by coughing and expectorating
Measuring for an
Oropharyngeal Airway
Measuring for a
Nasopharyngeal Airway
Suctioning an
Endotracheal
Tube
• Purpose
– Remove pulmonary secretions, blood, vomitus, or
foreign material from the airway
• Goal
– Remove secretions not accessible to cilia bypassed
by the tube itself
• Adverse effects
– Hypoxemia, cardiac dysrhythmias, trauma,
atelectasis, infection, bleeding, and pain
Ensuring Endotracheal
Tube Is Stabilized and
Removing Old Tape
Assessment Made When
Suctioning a
Tracheostomy
• Lung sounds
• Oxygenation saturation level
• Respiratory status
• Pain
Providing Tracheostomy
Care
• Nurse is responsible for cleaning a nondisposable inner
cannula or replacing a disposable one.
• Tracheostomy dressing must be changed regularly to
prevent skin breakdown and infection.
• A newly inserted tracheostomy may require attention
every 1 to 2 hours.
• Meticulous care using aseptic technique is necessary.
Purposes of Chest Tubes
• Pleural effusion: drain fluid
• Hemothorax: drain blood
• Pneumothorax: drain air from the pleural space
Outcomes for a Patient
Following Removal of a
Chest Tube
• Patient remains free of respiratory distress.
• The insertion site will remain clean and dry without
evidence of infection.
• Patient will experience adequate pain control during the
removal process.
• Lung sounds will be clear and equal bilaterally.
• Patient will be able to increase activity tolerance
gradually.
Using a Bag and Mask
(Handheld Resuscitation
Bag)