Transcript Oxygenation for 101

Oxygenation
Unit Eight
Ahmad Ata
Objectives
 Out line the structure and function of the respiratory
system.
 Describe the process of breathing and gas exchange.
 Explain the role and function cardiovascular system in
transporting.
 Identify the factors effect on respiration.
 Identify the common Manifestation of impaired respiration.
 List the sign of obstructive air way.
 Identify and describe nursing measure to promote
respiratory function.
Respiratory system
 Oxygen: a clear, odorless gas that
constitutes approximately 21 percent of the
air we breathe for necessary all living cell.
 Respiration: is the process of gas exchange
between individual and the environment.
The process of respiration
involves several components:
1. Pulmonary ventilation: the movement of air
between the atmosphere and alveoli of the lungs.
2. Diffusion of oxygen and carbon dioxide between
alveoli and capillaries.
3. Transport of oxygen and carbon dioxide via blood
to tissues.
4. Diffusion of oxygen and carbon dioxide between
capillaries and cell.
Function of pulmonary system:

Ventilation: is the movement of air in and
out of the lung.

Respiration: is the process of gas
exchange.
Anatomy and physiology of
respiratory system:
 1) Upper respiratory tract:
 a) Nose – made of cartilage and bone and is
designed to warm, moisten, and filter air as
it comes into the system.
 b) Pharynx – (throat) conducts food and air;
exchanges air with Eustachian tube to
equalize pressure.
Cont
 C) Larynx – (voice box) connects the
pharynx and the trachea; made of cartilage;
contains vocal cords.
 D) Epiglottis – flap of tissue that covers
trachea; ensures food travels down the
esophagus.
Alveoli
Cont
 2) Lower Respiratory tract:
 Trachea – (windpipe) tubular passage way for air;
carries air to the lungs, C-shaped cartilage rings,
divides at end.
 Bronchi – pair of tubes that branch from trachea
and enter lungs; have cartilage, lining is ciliated &
secretes mucus.
 Bronchioles – tiny tubes lacking cartilage and cilia;
possess smooth muscle
 Alveoli – cup shaped structures at the end of the
bronchioles that resemble bunches of grapes; are
in direct contact with capillaries (gas exchange);
covered with SURFACTANT that keep them from
collapsing Alveoli.
 Lungs – paired, cone-shaped organs that are
surrounded by a pleural membrane, made of
elastic tissue, and divided into lobes
Mechanics of Breathing
 Inhaling (active process) – Air moves in.
Why?
 Gases move from an area of high pressure
to low pressure
 During inspiration – diaphragm pulls down
and lungs expand
 When lungs expand, it increase the volume,
which decrease the pressure inside lungs
 Lung pressure is lower than outside
pressure, so air moves in.
 Exhaling (passive process) – breathing out
 Diaphragm and muscles relax
 Volume in lungs and chest cavity decreases,
so now pressure inside increases.
 Air moves out because pressure inside is
HIGHER than OUTSIDE atmosphere.
Respiration:
 Exchange of O2 and CO2 between alveoli
and blood
 Partial pressure of O2 higher in alveoli than
blood so O2 diffuses into blood
 Partial pressure of CO2 higher in blood than
alveoli, so CO2 moves into alveoli in
opposite direction and gets exhaled out
Internal respiration
 Internal respiration
 Exchange of O2 and CO2 between blood and
tissues
 Pressure of O2 higher in blood than tissues so O2
gets release into tissues.
 Pressure of CO2 higher in tissue than in blood so
CO2 diffused in opposite direction into blood.
 CO2 Is a waste product.
 O2 Is used in cellular respiration
3 Muscle Groups of Inhalation
 Diaphragm:
– contraction draws air into lungs
– 75% of normal air movement
 External intercostals muscles:
– assist inhalation
– 25% of normal air movement
 Accessory muscles assist in elevating ribs:
–
–
–
–
sternocleidomastiod
serratus anterior
pectoralis minor
scalene muscles
Control of Breathing
 Breathing is regulated by the rhythmicity center in
the medulla and pons in brain stem.
 Carotid body is sensitive to level of oxygen.
 Control of Breathing
 The most important factor affecting chemo
sensitive center in the medulla oblogata is highly
responsive increase in blood is CO2 and O2 level.
  in arterial CO2 causes  in acidity of
cerebrospinal fluid (CSF)
 medulla  rate and depth of breathing
Pons and medulla
Factor effecting oxygenation:
 Environment: high altitude leads decrease lower
partial pressure and increase respiratory rate.
 Exercise: physical exercise lead to increase
respiratory rate.
 Life style: smoking, occupation.
 Health status: disease of cardiovascular disease.
 Narcotics: morphine decrease respiratory rate.
 Stress and anxiety.
 Respiratory alteration:
 Hypoxia: is condition of insufficient oxygen
anywhere in the body from the inspired gas
to the tissue. Cerebral function can tolerate
hypoxia for only 3 to 5 min before
permanent damage.
Sign of hypoxia:
 Rapid pulse.
 Rapid shallow respiration.
 Increase restlessness.
 Flaring nares.
 Cyanosis.
 Hypoventilation: inadequate alveolar
ventilation can lead to hypoxia may result
from disease of respiratory muscle, drug,
and anesthesia.
 Hypercabnia: accumulation of carbon
dioxide in the blood.
 Cyanosis: bluish discoloration of the skin
nails beds and mucosal membrane
Altered breathing pattern:
 Breathing pattern: rate, volume, rhythm,
effort of respiration.
 Normal respiration: (Eupnea) quite, rhythmic
and effortless.
 Tachypnea: rapid rate is seen with fevers,
metabolic acidosis, pain and Hypercabnia.
 Bradypnea: slow respiration rate, seen with
narcotics and increase intracranial pressure
from brain injury.
 Hyperventilation: increase movement of air
into and out of the lung.
 Dyspnea: difficult of breathing.
 Orthopnea: in ability to breathe except in an
upright position
 Obstructed air way:
 Partially or completely in upper and lower
respiratory tract.
Assessment
 Nursing history:
 Respiratory problem, cardiac problem, life style, cough and
sputum.
 Physical assessment:
 Inspection, palpation, percussion and auscultation.
 Diagnostic studies:
 Sputum specimen, throat culture, arterial blood samples.
 X- Ray examination.
 Bronchoscopy and laryngoscopy.
 Pulse oximetry: non invasive device measuring oxygen
saturation.
 Sputum collected for the following
reason:
 Culture and sensitivity: for identify a specific
microorganism.
 Cytology: to identify the origin, structure,
function and pathology cell.
 Acid bacillus: to identify the presence of
tuberculosis.
Nursing diagnosis:
 Ineffective air way clearance related to
accumulation of secretion.
 Ineffective breathing pattern related to
dyspnea.
 Altered tissue perfusion related to decrease
cardiac out put.
 Anxiety related to ineffective air way
clearance.
 Implementation:
 Positioning the client to allow to maximum chest
expansion.
 Encourage frequent changes in position.
 Encourage ambulating.
 Deep breathing exercise and coughing.
 Hydration to maintain moisturing of respiratory
tract mucous membrane and easily to move
respiratory secretion and decease incidence of
infection.