Jays george Msc Nursing

1. OXYGENATION
PRESENTED BY ,
MISS. JAYS GEORGE
1ST YEAR MSC (N)
DYPSON
PRESENTED TO,
MRS. PRICY JIMMY
CLINICAL INSTRUCTOR
DYPSON

3. INTRODUCTION
Air ,water and food are the three essentials of
life.
‘Oxygen’ the most important component of air
, is vital to all existence.
Oxygen is given when there is interference
with normal oxygenation of body tissues.
Oxygenation is the process that includes both
inspiratory and expiratory activities hence
there occurs the exchange transport of
respiratory gases.

4. DEFINITION
Oxygen is a colourless , odourless ,
tasteless and combustible gas.
Oxygen therapy is defined as the
administration of oxygen by
inhalation from a cylinder , piped
in system liquid oxygen
concentration by various methods
to relieve anoxemia.

5. PURPOSE
To facilitate normal
metabolism of the tissues.
To reduce/ correct arterial
hypoxemia (low
concentration of oxygen in
the blood )and tissue
hypoxia

6. FACTORS INFLUENCING OXYGENETION
There are mainly 4 factors causing
alteration in oxygenation ;
1) Physiological factors
2) Developmental factors
3) Life style
4) Environmental factors

7. Physiological factors
Decreased oxygen carrying capacity.
Decreased inspired oxygen
concentration(obstruction in airway tract
hypovolemia , increased metabolic rate).
Hyperventilation
Hypoventilation
Hypoxia
Condition affecting chest wall movement.

8. ALTERATION IN CARDIAC FUNCTIONING.
Illness and conditions affecting cardiac
strength of contraction , blood flow
through the heart or to the heart muscles ,
and decreased peripheral circulation cause
alterations in cardiac functioning.

9.  older adults experience alterations in
cardiac functions as a result of calcification
of the conduction pathways , thicker and
shifter heart valves caused by lipid
accumulation and fibrosis and decreases in
the number of pacemaker cells in the S.A
node.

10.  DISTURBANCES IN THE CONDUCTION.
Electrical impulses that do not originate
from the S.A node cause conduction
disturbances. these rhythm disturbances are
called dysrhythmias , meaning a deviation
from the normal sinus heart rhythm.

11. Sinus tachycardia : Regular rhythm rate >
100 – 180 bts/min, with normal p wave and
normal QRS complex.
Sinus bradycardia : Regular rhythm rate
less than 60 bts/min, normal P wave ,
normal PR interval and QRS complex.

13. Sinus dysrhythmia: sinus rhythm with cyclic
variation , slows during inspiration and increases
with expiration rate of 60 -100bts/min ; normal P
wave , normal PR interval , normal QRS complex.
Atrial fibrillation : no identifiable p wave,
irregular cardiac rate and rhythm.

14. Premature ventricular contractions : Irregular
Rhythm With Ectopic Beats , Rate Or Increased , P
Wave Absent In Ectopic Beat ; PR Interval Absent. QRS
Complex Widened And Distorted ; T Wave In
Opposition To R Wave.
 ventricular tachycardia : Rhythm Slightly
Irregular Rate100-200 bts/Min , P Wave Absent , PR
Interval Absent , QRS Wide And Bizarre , >0.12
Seconds.

15. Ventricular fibrillation : uncoordinated electrical
activity . No identifiable PQRS or T wave.
 Altered cardiac output : when the blood
volume gets decreased , the systematic and
pulmonary circulation can result in heart
failure.

16.  Impaired vulvular functions : it may be
congenital or acquired when size of the lumen of
the valves get narrowed. It is called stenosis ,
when there is widening of valves that leads to
regurgitation.
Angina pectoris : it is transient imbalance
between myocardial oxygen supply and demand.
The condition results in chest pain that is aching ,
sharp, tingling, burning or the feeling of pressure.

17. Myocardial infarction : It results from
sudden decrease in coronary blood flow or
an increase in myocardial oxygen demand
with out adequate coronary perfusion.

18.  ALTERATION IN RESPIRATORY
FUNCTIONING
 Hyperventilation :
It is a state of excessive ventilation
. If that required to eliminate normal
oxygen produced by cellular
metabolism. May be induced chemically
by anxiety occurs as the body tries to
compensate for metabolic acidosis.

19.  Hypoventilation : It is a condition where there is
less ventilation , not sufficient to eliminate
carbon dioxide produced by metabolic activities.
Hypoxia : It is the inadequate oxygenation of the
cells of tissues that leads to the necrosis of the
tissues and ineffective functioning at that level.

20.  Developmental factors : The developmental
stage of a patient and the normal aging
process affects tissue oxygenation.
 Infant and toddlers
School age children's and adolescents.
Young and middle age adults.
Older adults

21. Life style factors :
Nutrition
Exercise
Smoking
Substance abuse
stress

22. Environmental factors :
 Residence location
 occupation

23. OXYGEN ADMINISTRATION
DEVICES
OXYGEN FLOW RATE
HIGH FLOW
VENTURI MASK
MECHANICAL AEROSOL SYSTEMS
HIGHFLOW HUMIDIFIER SYSTEM
NON REBREATHER MASK
HIGHFLOW NASAL CANNULA
4 TO 12( L/MIN)
10 TO 15 (L/MIN)
MAXIMUM 60 LPM VIA NASAL PRONGS OR
CANNULA
LOW FLOW
NASAL CANNULA
NASAL CATHETER
TRANSTRACHEAL CATHETER
FACE MASK
TENT
ABOVE 5(L/MIN)
UPTO 5(L/MIN)
6 T0 12 LPM
2 TO 6 LITRES PER MINUTE
8 TO 12( L/MIN)

24. METHODS OF OXYGEN ADMINISTRATION
NASAL CATHETER : It Involves
Inserting An Oxygen Catheter/Sample
Rubber Catheter Into The Nose Up to
The Nasopharynx. It Is Needs To Be
Changed At least Every Eight Hours
And Inserted Into The Other Nostril, It
Is Also Painful And Can Cause Trauma.
Thus , It Is Less Desirable

25. NASAL CANNULA : A Nasal Cannula Is A
Simple Comfortable Devices. The
Cannula About 15cm (1/2 Inch) Long
Protrude From The Centre Of Disposable
Tube And Are Inserted Into The Nares.

27. TRANS-TRACHEAL OXYGEN : In
Trans Tracheal Oxygenation , Oxygen Is
Delivered Directly Into The Trachea Via A
Catheter( Small Intravenous Size) Into The
Trachea Through A Surgical Opening In
The Lower Neck.

29. OXYGEN MASK : Oxygen Mask Is
Device Used To Administer Humidified
Oxygen. It Is Strapped To Fit Snugly To
The Mouth And Nose And Is Secured In
Place With A Strap.

31. OXYGEN TENT: When A Patient Has Facial
Injuries Or For Any Other Reason Cannot Tolerate
An Oxygen Mask. Then This Method Can Be Used.
The Tent Is First Flooded With Oxygen And Then
A Flow Of 4-5 Litres Per Minute Is Given. This Will
Maintain A Service Of 40% - 50% In The Tent.

33. OXYGEN CYLINDERS

35. GENERAL INSTRUCTIONS
 oxygen should be treated as a drug ; the five rights
of medication administration also pertain to oxygen.
When using on oxygen cylinder or central supply
oxygen , use a regulator and humidifier.
Every part of the apparatus should be clean to
prevent infection.

36. When oxygen therapy is to be discontinued , it
should be done gradually.
Pay attention to conditions that can interfere with
the flow of oxygen from sources to the patient. this
may include tubing , loose connections and faulty
humidifying apparatus.
Airway keep a space oxygen cylinder in close vicinity.

37. Change nasal catheters at least every eight hours
or more often to prevent blockage of the nasal
catheter by a mucus.
Watch the patients receiving oxygen therapy
continuously to detect the early signs of oxygen
toxicity.
Since oxygen supports combustion ,fire protection
are to be taken when oxygen is on flow

38. PREPARATION OF THE PATIENT

39. PREPARATION OF
ARTICLES

40. PROCEDURE
STEPS
Wash hands.
Attach cannula/ catheter
, mask for oxygen tubing
and humidified oxygen
source adjusted to the
prescribed flow rate.
RATIONALE
To prevent cross
infection.
Prevents drying of
nasal and oral mucous
membranes and airway
secretions , use of a
humidifier prevents
drying of mucous
membrane.

41. Place tips of cannula
into the patient nares, if
mask apply snuggly to
face.
Check cannula /
equipment every eight
hours.
Directs flow of oxygen
into the upper
respiratory tract,
prevents loss of oxygen.
Ensures patency of
cannula and oxygen
flow, also ensures safe
delivery of prescribed
oxygen.

42. Keep the humidification jar
filled at all times.
Observe the patients nares
and superior surface of
both ears and skin
breakdown.
Prevents inhalation of
dehumidified oxygen
prevents drying of
mucus membranes.
Oxygen therapy can dry
nasal mucosa, pressure
on ears from cannula
tubing's / elastic can
cause skin irritation

43. Check the oxygen flow
safe and the physicians
orders every eight hours.
Wash hands before
removing the oxygen
mask or tube.
Ensures delivery of the
prescribed oxygen
flow rate.
Reduces transmission
of micro-organisms.

44. Inspect the patient for
relief of symptom's
associated with hypoxia.
Record procedure in the
nurses notes.
Indicates the hypoxia is
reduced / treated.
Document correct use
of oxygen therapy and
the patients response.

45. AFTER CARE OF PATIENTS AND THE ARTICLES
 Stay with the patients till he / she is at care.
 Keep the patient warm and comfortable .
 Evaluate the patients progress by observing the
vital signs and symptom's.
 Watch the patients progress by observing the vital
signs and symptoms.
 Record procedure with date and time.

46.  Request for an arterial blood gas analysis at specified
intervals to make sure hypoxia is treated.
 Take all articles to the utility room.
 Clean nasal catheter with cold water then warm soapy
water and finally with clean water (if disposable ) boil
and store or send for sterilization.

47. COMPLICATIONS