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Chapter 21 Oxygenation. Assessing Oxygenation. Physical assessment Monitoring the client’s respiratory rate Observing breathing pattern and effort Checking chest symmetry Auscultating lung sounds. Arterial blood gases measure: Partial pressure of oxygen dissolved in plasma
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Chapter 21 Oxygenation
Assessing Oxygenation • Physical assessment • Monitoring the client’s respiratory rate • Observing breathing pattern and effort • Checking chest symmetry • Auscultating lung sounds
Arterial blood gases measure: • Partial pressure of oxygen dissolved in plasma • Percentage of hemoglobin saturated with oxygen • The pH of blood
Pulse oximetry • Composed of a sensor and a microprocessor • Noninvasive, transcutaneous technique for periodically or continuously monitoring the oxygen saturation of blood
Promoting Oxygenation 1-Positioning: Fowler’s position
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.
-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.
Oxygen Therapy • Oxygen sources • Wall outlet • Portable tanks • Liquid oxygen unit • Oxygen concentrator
Equipment used in oxygen administration • Flowmeter
Common delivery devices • Nasal cannula
Masks • Simple mask • Partial rebreather mask • Non-rebreather mask • Venturi mask
Additional delivery devices • Nasal catheter
Oxygen tent and CPAP mask (continuous positive airway pressure): Very helpful for patients with sleep apnea.
Transtracheal oxygen • Oxygen hazards • Fire potential • Oxygen toxicity
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
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
Nursing Implications • Nursing diagnoses: hypoxemia or hypoxia • Ineffective breathing pattern • Impaired gas exchange • Anxiety • Risk for injury (related to oxygen hazards)
Ineffective Breathing Pattern (Refer to Nursing Care Plan 21-1in the textbook.)