Oxygenation

NURS207 Final

Oxygenation

The process of delivering oxygen to the body's tissues.

Hypoxemia

Low oxygen levels in the arterial blood.

Hypoxia

Insufficient oxygen delivery to tissues.

Inhalation

Air flow into the lungs due to contraction of the diaphragm and intercostal muscles.

Exhalation

Air expelled from the lungs due to relaxation of the diaphragm and intercostal muscles.

Gas Exchange

The process where oxygen diffuses into blood from alveoli, and carbon dioxide diffuses out.

Ventilation

The process of moving air in and out of the lungs.

Perfusion

The delivery of oxygenated blood to tissues.

Hypoventilation

Insufficient breathing that causes CO₂ buildup.

Hyperventilation

Increased breathing rate and depth resulting in decreased CO₂ levels.

Airway Obstruction

Blockage of the upper or lower respiratory tract that impairs ventilation.

Asthma

A condition characterized by wheezing and difficulty breathing due to airway inflammation.

COPD

Chronic Obstructive Pulmonary Disease, a progressive lung disease that obstructs airflow.

Pneumonia

An infection that inflames the air sacs in one or both lungs.

Pleural Effusion

Excess fluid in the pleural space surrounding the lungs.

Pneumothorax

Air in the space between the lung and chest wall leading to lung collapse.

Sputum Collection

The process of obtaining mucus from the respiratory tract for diagnostic purposes.

Oxygen Therapy

The administration of oxygen to increase the amount of oxygen in the body.

Tracheostomy

A medical procedure to create an opening through the neck into the trachea.

Factors that interfere with effective ventilation and respiration

Physiological respiratory conditions; environmental impacts; lifestyle and medication effects; age-related respiratory changes.

How conditions diseases and environmental factors affect oxygenation

Respiratory diseases impair airflow and gas exchange; pleural conditions limit lung expansion; pulmonary embolism reduces oxygen delivery; environmental and lifestyle factors decrease oxygen availability; medications depress the respiratory center.

Assessments for clients with altered oxygenation

Respiratory rate

How growth and development affect oxygenation

Infants have high respiratory rates; toddlers have aspiration risk; adolescents face smoking and vaping risks; older adults have decreased lung elasticity

Nursing interventions to promote oxygenation

Positioning; breathing techniques; incentive spirometry; airway clearance; oxygen therapy; monitoring for oxygen toxicity and skin breakdown.

Safe administration of oxygen

Correct equipment setup; appropriate oxygen delivery device selection; fire safety precautions; monitoring oxygen saturation; awareness of hypoxic drive.

Oral / oropharyngeal suctioning

Clean procedure with PPE; insert catheter along the gum line toward the pharynx; rinse catheter after suctioning.

Tracheostomy site care

Assess stoma and secretions; sterile technique for suctioning; hyperoxygenate before suctioning; clean skin; replace trach ties safely.

Ambu bag

Used to provide mechanical ventilation when spontaneous breathing is inadequate.

Sputum specimen collection

Collect early morning; rinse mouth; encourage deep breathing and coughing; obtain sputum not saliva; deliver to lab within 30 minutes; use PPE.

Chest tube care

Maintain upright drainage system; monitor drainage amount and type; assess water seal chamber; gentle bubbling in suction chamber; identify air leaks; prevent tube dislodgement.

Give examples of factors that interfere with effective ventilation and respiration

- Physiological Respiratory Conditions

Diseases like asthma, emphysema, bronchitis, and COPD impair airflow and gas exchange, affecting ventilation effectiveness.

- Environmental Impacts

High altitude, pollution, and occupational hazards reduce oxygen availability and damage lung tissue, increasing respiratory effort.

- Lifestyle and Medication Effects

Smoking raises chronic respiratory disease risk; narcotic analgesics depress the respiratory center reducing ventilation.

- Age-Related Respiratory Changes

Infants have higher respiratory rates; older adults face decreased lung elasticity and higher infection risk.

Describe how various conditions, diseases, and environmental factors affect oxygenation.

- Respiratory diseases such as asthma, emphysema, chronic bronchitis, COPD, and pneumonia impair airflow and alveolar gas exchange

- Pleural conditions (pleural effusion, pneumothorax, hemothorax) prevent full lung expansion

- Pulmonary embolism blocks blood flow to lung tissue, reducing oxygen delivery

- Environmental factors such as high altitude, pollution, and occupational hazards decrease oxygen availability and damage lung tissue

- Lifestyle factors including smoking increase the risk of chronic respiratory disease

- Medications such as narcotic analgesics depress the respiratory center and reduce ventilation

Recognize appropriate assessments for clients with altered oxygenation.

- Observation of respiratory rate, depth, and pattern

- Use of accessory muscles and chest symmetry

- Patient positioning (e.g., tripod position)

- Physical signs such as clubbing or jugular venous distention (JVD)

- Lung auscultation to detect wheezes, crackles, or diminished breath sounds

- Pulse oximetry to assess oxygen saturation (values <92% indicate hypoxemia)

- Advanced diagnostics including arterial blood gases (ABGs), chest X-ray, and pulmonary function tests

Explain how growth and development affect oxygenation.

- Infants have high respiratory rates (30–60/min) and may experience brief pauses; apnea >20 seconds is abnormal

- Toddlers have declining respiratory rates but increased aspiration risk due to developmental behaviors

- Adolescents typically have stable respiratory function but face risks from smoking and vaping

- Older adults experience decreased lung elasticity, reduced ciliary action, weakened cough reflex, activity intolerance, and increased infection risk

Describe nursing interventions to safely promote the client's oxygenation.

- Positioning (Fowler’s, orthopneic, prone positioning, and “good lung down” for unilateral lung disease)

- Breathing techniques such as pursed-lip breathing and diaphragmatic breathing

- Incentive spirometry to promote lung expansion and prevent atelectasis

- Airway clearance through coughing, deep breathing, and chest physiotherapy

- Oxygen therapy with appropriate device selection and monitoring

- Monitoring for oxygen toxicity and skin breakdown from devices

Apply concepts related to safe administration of oxygen in a controlled setting according to evidence-based guidelines.

- Correct equipment setup (flowmeter, humidifier, delivery device)

- Selection of the appropriate oxygen delivery device:

-Nasal cannula (24–44% FiO₂)

-Simple mask (40–60% FiO₂)

-Non-rebreather mask (95–100% FiO₂)

-Venturi mask for precise FiO₂ (especially in COPD)

-High-flow nasal cannula for heated, humidified oxygen

- Fire safety precautions (no smoking, avoid flammable materials)

- Monitoring oxygen saturation and patient response

- Awareness of hypoxic drive in COPD patients

Apply concepts for promotion of oxygenation related to the following skills: oral suctioning, tracheostomy site care, use of an ambu bag, obtaining a sputum specimen, and chest tube care, in a controlled setting.

Oral / Oropharyngeal Suctioning

- Clean procedure with PPE

- Insert the catheter along the gum line toward the pharynx

- Rinse the catheter after suctioning

Tracheostomy Site Care

- Assess stoma and secretions for color, odor, and consistency

- Use sterile technique for suctioning

- Hyperoxygenate before suctioning

- Clean skin, remove crusted secretions, and replace trach ties safely

Ambu Bag (Manual Ventilation)

- Used to provide mechanical ventilation when spontaneous breathing is inadequate

- Ensures oxygen delivery during respiratory failure or emergencies

Sputum Specimen Collection

- Collect early morning before eating or drinking

- Client rinses mouth first

- Encourage deep breathing and coughing

- Obtain 1–2 teaspoons of sputum (not saliva)

- Deliver to the lab within 30 minutes

- Use appropriate PPE

Chest Tube Care

- Maintain an upright drainage system

- Monitor drainage amount and type

- Assess the water seal chamber for tidaling and bubbling

- Ensure gentle bubbling in the suction chamber

- Identify air leaks and prevent tube dislodgement