Arterial blood oxygen

saturation
Pulse oximeter- a
noninvasive device that
estimates the client
oxygen saturation
It can detect hypoxemia
(reduced oxygen in the
blood) before clinical
signs and symptoms
develop
NORMAL : 95%-
100%

BELOW 70% IS
LIFE-
THREATENING

Hypoxia
Altered Breathing Patterns
Obstructed Airway
Condition of insufficient oxygen anywhere in
the body, from the inspired gas to the tissues

MANIFESTATIONS:
Rapid pulse
Rapid, shallow respirations and dyspnea
Restlessness and light- headedness
Flaring of the nares
Substernal and intercostal retractions
Cyanosis (bluish discoloration of the skin,
nailbeds, and mucous membranes)
Hypercarbia (Hypercapnia)- a condition
where carbon dioxide accumulates in the
blood along with hypoventilation

Tachypnea, bradypnea, apnea, orthopnea,
dyspnea
Kussmauls breathing- blowing off carbon
dioxide through deep and rapid breathing
Cheyne- Stokes respiration- rhythmically
waxing ad waning of respirations from very
deep to very shallow breathing and
temporary apnea
Biots (cluster) respiration- shallow breaths
interrupted by apnea
Upper airway (nose, larynx, pharynx)
obstruction: because of foreign object (e.g.
food)
Lower airway (bronchi, lungs) obstruction:
because of increased accumulation of mucus

NURSING RESPONSIBILITY/ PRIORITY:
Maintain a PATENT AIRWAY

Sit straight and stand erect for full lung
expansion
Exercise regularly
Breathe through the nose
Breathe in to expand the chest fully
Do not smoke and avoid secondhand smoke
Do not incinerate garbage in the house

Purpose: TO REMOVE SECRETIONS from
the airways
Deep breathing exercises are abdominal
(diaphragmatic) breathing and pursed- lip
breathing
Coughing exercises are controlled and huff
coughing

Semi- sitting position
Flex knees to relax the muscles of the abdomen
Breathe through the nose, keeping the mouth
closed
Then purse your lips as if about to whistle and
breathe out slowly and gently, making s slow
whooshing sound without puffing the cheeks.
Tighten the abdominal muscles while breathing
out. Count to 7 during exhalation
Use this exercise whenever feeling short of breath
Inhale deeply and hold your breath for a few seconds
Cough twice. The first cough loosens the mucus; the
second cough expels the mucus
For huff coughing, lean forward and exhale sharply
with a huff sound.
Inhale by taking rapid short breaths in succession
sniffing to prevent mucus from moving back
Rest
Avoid forceful coughing and prolonged episodes of
coughing because these may cause fatigue and
hypoxia

HUMIDIFIERS- devices that add water to
inspired air
These are used to provide moistened air,
prevent mucous membranes from drying and
becoming irritated and to loosen secretions
for easier expectoration (spitting out)
Administration of oxygen
Purpose: TO PREVENT HYPOXIA
Equipment:
flow meter,
humidifier bottle with distilled or tap water,
oxygen tubing
cannula/ face mask/ face tent
oxygen tank
Tape and padding

Most common and inexpensive device
It delivers low concentration of oxygen (24%-
45%) at flow rates of 2- 6 L per minute

Cover the clients nose and mouth may be
used for oxygen inhalation
Exhalation ports on the sides of the mask
allow inhaled carbon dioxide to escape
A. Simple face mask- delivers 40%- 60% at
liter flows of 5-8 LPM


B. Partial Rebreather mask- delivers oxygen
concentration of 60% - 90% at liter flows of 6-
10 LPM

C. Nonrebreather mask- delivers highest
oxygen concentration of 95%- 100% at liter
flows of 10-15 LPM


Venturi mask- delivers oxygen concentrations
varying from 24%- 40% OR 50% at liter flows
of 4-10 LPM

Can replace oxygen masks when masks are
poorly tolerated by the clients.