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8/10/2019 conceopts 0f O2-CO2.ppt_co0

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CHAPTER 50

NUR 107

2014

Oxygenation

O2 CO2


2/94

Copyright 2012by Pearson

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3/94

O&'(ENAT$ON

O2 is taste)ess# "o)or)ess

A""o!nts 21* at+ospheri" air

Oxygen !se, +aintain ae-!ate "e))!)ar

oxygenation%.or Tx% o/ a"!te an "hroni" respiratory

prob)e+s

Hypoxe+ia inae-!ate oxygen )ee)s in

the b)oo

O2/)o rates ary atte+pt to +aintain

3aO2 2*


4/94

H'PO&E6$A

Ta"hypnea

Ta"hy"aria

Rest)essness

E)eate P

38in Pa))or

Respiratory istress

Nasa) /)aringUse o/ a""essory +!s")es

Aentitio!s )!ng so!ns

Cyanosis

Con/!sion 9 st!por

raypnea ray"aria

Hypotension

Caria" ysrhyth+ias

Early signs

Late signs


5/94

O&'(ENAT$ON

Assess:+onitor resp% rate# rhyth+# ebth 9 e//ort

6onitor 3aO2; A(:s

3aO2 ? 2* re-!ire n!rsing interentions

3aO2 ? @* = e+ergen"y

3aO2 ? @0* = )i/e threatening


6/94

O&'(EN TO&$C$T'

6ay res!)t /ro+ high "on"entrations o/ oxygen

Be)iering 50*

ong !rations o/ oxygen therapy

6ore than 24 4@ hrs%

3y+pto+s, non=pro!"tie "o!gh# s!bsterna)

pain# nasa) st!//iness# N:D# heaa"he# sore

throat# hypoenti)ation%


7/94

O&'(EN TO&$C$T'

$nterention

Be"rease oxygen as soon as "onition per+its

Use )oest oxygen ne"essary to +aintain

ae-!ate 3aO2

6onitor A(s

Use CPAP# iPAP or PEEP hi)e on a enti)ator

He)ps to e"reases the a+t% o/ oxygenneee /or an ae-!ate )o )ee) itho!t

"o+pro+ising )!ng "o+p)ian"e


8/94

O&'(EN=$NBUCEB

H'PODENT$AT$ON

6ay o""!r in COPB ith "hroni" hypoxe+iaan hyper"arbia

COPB pts re)y on )o )ee)s o/ arteria) oxygen

as their pri+ary rie /or breathing3!pp)e+enta) oxygen at high )ee)s "an

e"rease or e)i+inate the respiratory rie6onitor /or resp% epression

O2 s!pp)e+ent +!st be at 1=2:+inDent!ri +as8 i/ to)erate6onitor OC


9/94

STRUCTURES OF THE

UPPERRESPIRATORY TRACTCopyright2

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NoseSinuses/nasal

passagesPharynTonsils an! a!enoi!s"aryn# epiglo$$is%

glo$$is%&o'al 'or!s


10/94


11/94

AEO"I here gas ex"hange ta8es p)a"e

A)eo)ar="api))ary +e+brane

3!r/a"tant )ipoprotein

pro!"e by a)eo)ar "e))sa"ts )i8e a etergent

re!"ing a)eo)ar s!r/a"e

tension%

itho!t s!r/a"tant# )!ng expansion be"o+esex"eeing)y i//i"!)t an the )!ngs "o))apse%

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12/94

LUNG COMPLIANCE

Co+p)ian"e )!ng re"oi)Abi)ity o/ the )!ngs an thorax to expanNe"essary /or nor+a) inspiration 9

expirationContin!a) tenen"y o/ the )!ng to "o))apse

aay /ro+ the "hest a))Be"rease in iseases s!"h as

p!)+onary ee+a# "ongenita) str!"t!ra)abnor+a)ities# /x ribs

Be"reases ith aging


13/94

ENTI"ATION

Inspira$ion 0 inhala$ion

Epira$ion 0 ehala$ion

en$ila$ion is !epen!en$

upon#Clear air+ay

In$a'$ CNS

In$a'$ respira$ory 'en$er

A!e1ua$e pul,onary'o,plian'e/re'oil

Thora'i' 'apa'i$y $o

'on$ra'$/epan!

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INSPIRATIONBiaphrag+ 9 inter"osta)s +!s")e "ontra"tionThora"i" "aity siFe in"reasesDo)!+e o/ )!ngs in"reases

$ntrap!)+onary press!re e"reases a)aysnegatieNegatie press!re in )!ngs "reates s!"tion that

ho)s the p)e!ra) +e+branes together as the

"hest expansAir r!shes into the )!ngs to e-!a)iFe press!reP!)+onary re"oi) enhan"es negatie press!re%


15/94

EHA"ATION3iaphrag, an! in$er'os$als relaolu,e o* $he lungs !e'reases

In$rapul,onary pressure risesAir is epelle!O$her en$ila$ion Fa'$ors#

In$rapul,onary pressureTi$al &olu,e


16/94

4AS ECHAN4E

O''urs a*$er $he al&eoli are &en$ila$e!Pressure !i5eren'es on ea'h si!e o* $he

respira$ory ,e,)ranes a5e'$ !i5usion

3i5usion o* oygen *ro, $heal&eoli in$o $he

pul,onary)loo! &essels

3i5usion o* 'ar)on !ioi!e*ro,

pul,onary )loo!

&essels in$o al&eoli

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A"EO"AR 3IFFUSION AN3PERFUSION

Bi//!sion= the pro"ess by hi"h oxygen an

"arbon ioxie are ex"hange at the

a)eo)ar="api))ary +e+brane%

Per/!sion= the b)oo /)o thro!gh

the p!)+onary "ir"!)ation%

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18/94

OY4EN TRANSPORT

Oygen is $ranspor$e! *ro, $helungs $o $he $issues

678 o* O2 'o,)ines +i$h Hg) in

R(Cs an! is 'arrie! $o $issues asoyhe,oglo)in

Re,aining oygen is !issol&e!

an! $ranspor$e! in plas,a an!'ells


19/94

CAR(ON 3IOI3ETRANSPORT

9us$ )e $ranspor$e! *ro, $he $issues$o $he lungs

CO2 is 'on$inually pro!u'e! in 'ell

,e$a)olis,:;8 is 'arrie! insi!e $he R(C as

)i'ar)ona$e


20/94

RESPIRATORYRE4U"ATION

Neural regula$ion >respira$ory 'en$er? is'on$rolle! )y $he ,e!ulla o)longa$a an!pons o* $he )rain

Che,i'al regula$ion

CO2 sensi$i&e @,e!ullaHy!rogen ion 'on'en$ra$ion3e'rease O2 'on'en$ra$ion @'aro$i' B

aor$i' )o!ies3e'rease ar$erial O2 'on'en$ra$ion@'he,ore'ep$ors

E,physe,a0 O2 'on'en$ra$ion plays a role

in regula$ing respira$ions


21/94

T$BA DOU6E

Begree o/ "hest expansion !ringnor+a) breathing is +ini+a)# re-!iring)itt)e energy expenit!re%

500+) o/ air is inspire an expireith ea"h breath in the nor+a) a!)t


22/94

CONTINUED

$nspiratory resere o)!+e = is thea+o!nt o/ air that "an be inha)e a/ter anor+a) or tia) inspiration

Expiratory resere o)!+e = a+o!nt o/air that "an be /or"ib)y exha)e a/ter nor+a) ortia) expiration

Resi!a) Do)!+e = the a+o!nt o/ air re+ainingin the )!ngs a/ter /or"e +axi+a) expiration


23/94

CONTINUED

Dita) Capa"ityThe DC is the +axi+a) a+o!nt o/ air

that "an be exha)e a/ter +axi+a)inspiration%

The DC is the tota) o/ the tia)

o)!+e# inspiratory resere o)!+e#

an expiratory resere o)!+e%


24/94

RESPIRATORY

ALTERATIONSHypoxia

$ns!//i"ient 02anyhere in the boy

Signs of Hypoxia

Rapi p!)se

Rapi sha))o respirations an

yspnea:/)aring o/ nares:"yanosis

$n"rease res)t)essness or)ightheateness:"on/!sion


25/94

SIGNS/SYMPTOMS OF

HYPOXEMIAEar)y Ta"hy"aria Ta"hypnea Rest)essness

38in pa))or E)eate P 3x resp% istress

Nasa) /)aring

A"sessory +!s")esa# !ng so!ns

ate

Con/!sion# st!por

Cyanosis s8in 9

+!"o!s +e+branes raypnea

ray"aria

Hypotension

Caria" yshyth+ias


26/94

HYPERCARBIA

Hyper"arbia

Hypoenti)ation# CO2a""!+!)ation

Cyanosis

)!ish is"o)oration o/ the s8in# nai)bes#

an +!"o!s +e+branes# !e to re!"e

He+og)obin "on"%


27/94

CARDIOVASCULAR

ALTERATIONSConitions that A//e"t,

The /!n"tion o/ the heart as a p!+p

)oo /)o to organs an tiss!esCo+position o/ the b)oo an its

abi)ity to transport 02an C02


28/94

CARDIOVASCULAR ALTERATIONS

Be"rease Caria" O!tp!t6$# Heart .ai)!re# P!)+onary

Ee+a

$+paire Tiss!e Per/!sion

$s"he+ia# T$A=stro8e# P!)+onaryE+bo)i

)oo A)terationsHypoo)e+ia# Ane+ia


29/94

RESPIRATORY EFFORTS

Accessory Muscles:$n"rease )!ng o)!+e !ring inspirationC)ients ith COPB# espe"ia))y e+phesy+a#

/re-!ent)y !se a""essory +!s")es to in"rease

)!ng o)!+e%N!rse +ight obsere ")ai")es being e)eate

hen breathing; retra"tionsRes!)ts in energy expenit!re hi"h in"reases

+etabo)i" rate$n"rease +etabo)i" rates in"rease the nee /or

+ore O29 the nee to e)i+inate CO2


30/94

FACTORS INF"UENCIN4RESPIRATORY FUNCTION

AgeEn&iron,en$

"i*es$yle% A'$i&i$y

Heal$h s$a$us9e!i'a$ions

S$ress% E,o$ions

(o!y posi$ion(o!y $e,p-/ En&iron,en$ $e,p


31/94

(REATHIN4 PATTERNS

3uring inspira$ions% $he $hora'i''a&i$y ,us$ ha&e a lo+erpressure $han $he a$,osphere-

Eupenea nor,al(ra!y'ar!ia 0 D= )rea$hs/,inTa'hypnea 2 )rea$hs/ ,in

Hypo&en$ila$ion shallo+%irregular )rea$hing


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Breathing Patterns

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SY9PTO9S OF I9PAIRE3RESPIRATORY FUNCTION

HypoiaAl$ere! )rea$hing pa$$ernsO)s$ru'$e! or par$ially o)s$ru'$e!

air+ay


34/94

HYPOIA

Con!i$ion o* insuG'ien$ oygenany+here in $he )o!y

Rapi! pulse

Rapi!% shallo+ respira$ions an!!yspnea In'rease! res$lessness or

ligh$hea!e!ness

Flaring o* naresSu)s$ernal or in$er'os$al re$ra'$ionsCyanosis


35/94

A"TERE3 (REATHIN4PATTERNS

Apnea 'essa$ion o* )rea$hinguss,aul?s )rea$hing !eep rapi!

)rea$hinghyper&en$ila$ion r/$ ,e$a)oli' a'i!osis(o!y a$$e,p$s $o )lo+ o5 CO2

Cheyne0s$o.es +aing B +aningrespira$ions

(io$?s respira$ions shallo+ 'lus$ers o*)rea$hs $ha$ are in$errup$e! )y apneaOr$hopnea ina)ili$y $o )rea$h e'ep$ in an

uprigh$ posi$ion

3yspnea !i5- )rea$hing @SO(


36/94

O(STRUCTE3 AIRAY

Complete or partial obstruction may occur

anywhere along the resp. tract

Aspiration of foreign object

Tongue falls back & occludes oropharynxSecretions or mucus accumulation


37/94

ADVENTITOUS LUNG SOUNDS

Adventitious abnormal

!artial obstruction

"ow#pitch snoring sound during inhalation

Complete obstruction

$o chest movement

%nability to cough or speak

Sternal & intercostal retractionsStridor high#pitch sound during inspiration


38/94

ASSSS'$T

Hea)th Hx, physi"a) 9 /!n"tiona) prob)e+ yspnea# pain# a""!+!)ation o/ +!"!s#

heeFing# he+optysis# ee+a o/ the /eet#

/atig!e# ea8ness3:3x o/ yspnea# orthopnea# "o!gh

6aGor s:sx yspnea# sp!t!+ pro!"tion#

"hest pain# heeFing# ")!bbing o/ /ingers#

he+optysis# "yanosisC)!bbing o/ nai)s# sign o/ )!ng isease /o!n in

pts% ith "hroni" hypoxi" "onitions


39/94

PHYSICAL ASSESSMENT

reathing pattern to be assesse itho!t ")ientsaareness%

Nor+a) respiratory rate ranges 12=20bp+% Rate greater than 20


40/94

PHYSICAL ASSESSMENT

Hea)th 3tat!s= "hroni" i))ness "an "a!se

+!s")e asting in")!ing +!s")es o/ the

respiratory syste+

Rena):Caria"= "reate /)!i oer)oa# a//e"trespiratory /!n"tioning

Chest Tra!+a=i+pairs abi)ity to expan an

"ontra"t "hest


41/94

PHYSICAL ASSESSMENT

Consierations re)ate to the ")ients nor+a)

breathing patterns# position# hea)th

prob)e+s# +ei"ations or therapies# an

"arioas"!)ar /!n"tion a//e"tingrespirations sho!) be +ae

Opiois= Bepress respiratory "enter#

e"reasing rate an epth o/ respirations


42/94

PHYSICAL ASSESSMENT

Eniron+ent= A)tit!e#heat# "o)# an airpo))!tion a//e"t oxygenation%

Po))!te air= Heaa"he# iFFiness# "o!ghing#

"ho8ing# an stinging o/ eyes

Physi"a) (roth an Bee)op+ent

Conitions s!"h as s"o)iosis a//e"t breathing

patterns an "a!se air trapping%

Obese peop)e are o/ten 3O# ith a"tiity

!e to a)eo)i at the base o/ the )!ngs are not

sti+!)ate to expan /!))y

ASSSS C(ST


43/94

ASSSS C(ST

C)$*%+,-AT%)$

1% arre) "hest = o""!rs as a res!)t o/ oerin/)ation o/ the )!ngs

2% .!nne) "hest o""!rs hen there is

epression o/ the )oer portion o/ the stern!+

I% Pigeon "hest isp)a"e+ent o/ the stern!+

4% Jyphos"o)iosis Abnor+a) "!rat!re o/ the

spine

3"o)iosis# Jyphosis# arosis

5% .)ai) Chest


44/94

ASSSS'$T

Cyanosis a )luish 'oloring o* $he s.inJin!i'a$es hypoia

3e$er,ine! )y a,$- o* !eoygena$e!he,oglo)in in $he )loo!

Cyanosis appears +hen ;g/!" o*unoygena$e! he,oglo)in

A person +i$h a he,oglo)in o* D;g/!" +illno$ sho+ 'yanosis un$il ;g/!" o* $ha$)e'o,es unoygena$e!

Ane,i' p$s- rarely sho+ 'yanosis-


45/94

ASSESSMENT

Assess )ips# s8in# an nai) bes /or signs o/

periphera) "yanosis# s!"h as b)!e=gray tinge

or ")!bbing o/ the nai)s%

C)!bbing is a sign o/ )ong=ter+# i+paireoxygenation%


46/94

LISTEN TO BREATH

SOUNDSAbnormal breath sounds

Normal breath sounds vs. Adventious

Crackles, wheezes, friction rubs

Voice Sounds vocal resonanceBronchophony intense & clear sound

Egophony distorted voice sounds

Whispered pectoriloquy a subtlesound

x


47/94

SPUTUM

"ung?s rea'$ion $o irri$an$s or nasal!is'harge

(a'$erial in*e'$ion 0 $hi'.% yello+% green%rus$ 'olor spu$u,

iral in*e'$ion $hin% ,u'oi! spu$u,

"ung $u,or pin.0$inge! spu$u,

Pul,onary e!e,a pro*use% *ro$hy

spu$u,"ung a)'ess% )ron'hie$osis *oul

s,elling spu$u, ' )a! )rea$hx


48/94

COUGH

Ti+ing; /re-!en"y= oes it get orse# hatagraates itK

Chroni"# A"!te# or Paroxys+a)

Pro!"tie or nonpro!"tie

Bry or +oist

ar8ing# Hoarseness# Ha"8ing

x


49/94


50/94

CLUBBING

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3ign o/ )!ng isease /o!n in pts% ith

"hroni" hypoxi" "onitions# "hroni"

)!ng in/e"tions#

9+a)ignan"ies%

3ponginess o/ nai)

bes ith )oss o/

nai)=be ang)e


51/94

CLUBBING


52/94

ASSESS FOR CHEST PAIN

Pain Asso'ia$e! +i$h pul,onary or 'ar!ia'!isease

9ay o''ur +i$h pneu,onia% Pul,on!ye,)oli% lung in*ar'$ion% pleurisy% 'an'er

Relie* ,easures# analgesi'% regionalanes$he$i's


53/94

NURSING MEASURES TO

PROMOTE RESPIRATORY

FUNCTIONEnsure a patent airwayPositioning

Encouraging deep

breathing, coughingEnsuring adequate

hydration

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54/94

3PUTU6, RE$E. 6EA3URE3Be"rease is"osity = in"rease hyration $nha)ation o/ aeroso)iFe so)!tions3top s+o8ing inter/eres ith "i)iary a"tion#

in"reases bron"hia) se"retions# "a!ses

in/)a++ation# re!"es s!r/a"tant%N!trition "onsierations = +ay be

"o+pro+ise !e to the s+e)) or taste o/sp!t!+

x

THERAPEUTICMEASURESTO


55/94

THERAPEUTIC MEASURES TO

PROMOTE RESPIRATORY

FUNCTIONMedicationsIncentive spirometryChest PTPostural drainageOxygen therapyArtificial airwaysAirway suctioningChest tubes


56/94

ASSESSMENT OF COPD

L!estions regaring yspnea# "o!gh#sp!t!+ pro!"tion# re"ent "o)s

N!rse notes any post!ra) "hanges inrespiratory rate

Respiratory rate +ay be in"rease anexpiration pro)onge%


57/94

COPD

Chest +ay hae an in"rease anterior=

posterior ia+eter


58/94

TREATMENT

(oa) is to a))eiate a"!te sy+pto+s an

preent "o+p)i"ations% Treat+ent in")!es,

ron"hoi)ators to i+proe air/)o

Corti"osterois to e"rease in/)a++ationo /)o O2 i/ PaO2 is )ess than 55 or

3aO2 )ess than @@*

Antibioti"s


59/94

NURSING DIAGNOSES

.o"!s on the i+pa"t o/ physio)ogi" "hanges

on the patients /!n"tioning%

Chroni" yspnea "an in/)!en"e a"tiity

to)eran"e an abi)ity to "are /or the se)/Co!ghing an 3O "an ist!rb s)eep an

"ontrib!te to /atig!e an ea8ness

Extra or8 on breathing "an in"rease

"a)orie re-!ire+ents b!t eating an

sa))oing +ay be )i+ite to yspnea%


60/94

NURSING INTERVENTIONS

Tea"h e//e"tie breathing patterns

$+proe airay ")earan"e

$+proe (as Ex"hange

Ta8e +ei"ations as orereEn"o!rage ae-!ate n!tritiona) inta8e

Preent $n/e"tions


61/94


Ea)!ate A"tiity $nto)eran"e

Tea"h /a+i)y to assess patient orientation

Tea"h patient an /a+i)y abo!t COPB#

stress hea)thy behaiors# s+o8ing"essation# an signs o/ potentia) prob)e+s

Pro+ote hea)th s)eep patterns

Be"rease /ee)ings o/ poer)essness


62/94

ASTHMA

Chroni" $n/)a++ation o/ airays )eaing to

inter+ittent obstr!"tion

Progressie airay obstr!"tion !nresponsie to

treat+ent )eas to e+ergen"y sit!ation

.or+ o/ obstr!"tie p!)+onary isease


63/94

ETIOLOGY

$ntrinsi" etio)ogies=physi"a) an psy"ho)ogi"a)

stress# exer"ise in!"e

Extrinsi" etio)ogies= air po))!tants# a))ergi" response#

"o) an ry air# +ei"ations

iesprea spas+s o/ bron"hio)e s+ooth +!s")e

ith airay ee+a


64/94

ASSESSMENT

3eere yspnea:heeFing ith expiration

Co!gh:.ee)ing o/ "hest tightness

$n"rease heart rate an b)oo press!re

Extre+e rest)essness# anxiety# agitation Ta"hypnea an !se o/ a""essory +!s")es

PLANNINGAND


65/94

PLANNING AND

IMPLEMENTATION

Assess respiratory an oxygenation stat!s

A+inister s!pp)e+enta) O2

A+inister bron"hoi)ators

$enti/y:re+oe:aoi pre"ipitating /a"tors


66/94

EXPECTED OUTCOMES/EVAL

Absen"e o/ yspnea# "hest tightness# heeFing

Respiratory rate o/ 12 to 24

i)atera))y ")ear an e-!a) )!ng so!ns

A/ebri)eAe-!ate air ")earan"e o/ ")ear thin se"retions


67/94

INCENTIVE SPIROMETRY

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CHEST PHYSIOTHERAPYCopyright2

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OXYGEN THERAPY

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OXYGEN THERAPY

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Simple face mask

Partial rebreathermask

Nasal cannula


71/94

OXYGEN THERAPY

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Nonrebreather mask

Venturi mask

OXYGENHOOD


72/94

OXYGEN HOOD

OxygenTent

Oxygen Mask


73/94

HUMIDIFIER VIDEO

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(a'. $o 3ire'$ory


74/94

ARTIFICIAL AIRWAYS

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Oropharyngeal Airway

Nasopharyngeal Airway


75/94

ARTIFICIAL AIRWAYS

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TRACHEOSTOMY TUBE

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CHEST DRAINAGE SYSTEM

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For pneumothorax or

hemothorax

Tubes are inserted into

the pleural cavity to drainfluid/blood and restore

negative pressure

Closed system with a

suction control chamber &water seal chamber


78/94

PNEUMOSTAT

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For pneumothoraxwith small amounts

of fluid drainage

One way valveprevents back flow

HEI9"ICH CHEST


79/94

HEI9"ICH CHEST3RAINA4E A"E

Use! +i$h a,)ula$ory pa$ien$sAllo+s air $o es'ape *ro, $he 'hes$

'a&i$y +i$hou$ air re0en$ering

3oes no$ 'olle'$ Lui!

Copyright 2012 by Pearson Education, Inc.


80/94

3ESIRE3 OUTCO9ES

9ain$ain a pa$en$ air+ay I,pro&e 'o,*or$ an! ease o* )rea$hing

9ain$ain or i,pro&e pul,onary

&en$ila$ion an! oygena$ion I,pro&e a)ili$y $o par$i'ipa$e in

physi'al a'$i&i$ies

Pre&en$ ris.s asso'ia$e! +i$hoygena$ion pro)le,s

ARTERIALBLOODGASES


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ARTERIAL BLOOD GASES

ABGS

Ea)!ates respiratory /!n"tioning in a patient aneter+ine the a"t!a) )ee)s o/ CO2 an O2 in

arteria) b)oo%

The other a)!es erie /ro+ the A( ana)ysis are

Poer o/ hyrogen # HCOIArteria) sat!ration o/ the he+og)obin


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ABGS

ARTERIAL BLOOD GASES

pHpH 7.35 7.45PaCO2 35 45 mm Hg

PaO2 80 100 mm Hg

SaO2 92 98%HCO3 22 26 mEq/L

Base excess (BE) -2.0 to 2.0 mEq/L

CaO2 16-22 nL O2/dL


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OXYGEN SAFETY

No Smoking when in useKnow locations of closest fire extinguisher

Educate clients:

Hazards of smoking with oxygenTo wear cotton gowns, synthetics or wool

spark static electricity

Use of grounded electrical equipment

Assess clients whose main respiratory drive is

hypoxia for oxygen-induced hypoventilation

NANDANURSING


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NANDA NURSING

DIAGNOSES

AnxietyFatigue

Activity intolerance

Imbalanced nutrition: less than bodyrequirement


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Respiratory assessmentAppropriate application of oxygen delivery

systems


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NASAL CANNULA

delivers O2 at concentrations of 24-40%Flow rate 1-6 L/min

Safe and simple method, easy to apply

Flow rates may vary depending on depth of

clients breathing; dislodges easily

NC may cause nasal skin breakdown

Provide humidification for flow ratesM


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SIMPLE MASK

Covers nose & mouthDelivers 40% 60%

5 8 L/ min

For short-terms oxygen therapy

Minimum flow rate or 5 to ensure flushing of CO2 from

the mask

Mask may be poorly tolerated


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NON-REBREATHER MASK

Also covers nose & mouthOne-way valve and two exhalation ports

Delivers 80%-95% O2

10 15 L/minReservoir bag to stay 2/3 full during inspiration

& expiration

Delivers highest concentration possible


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VENTURI MASK

Also covers nose & mouthOne-way valve and two exhalation ports

Delivers 24%-55% O2

2 10 L/minDelivers the most precise oxygen

concentration with different size adaptors

Best suited for clients with chronic lungdisease

Expensive, & requires frequent

assessment


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PARTIAL REBREATHER MASK

Also covers nose & mouthDelivers 60%-75% O26 11 L/min

Reservoir bag with no valve, allows rebreathingup to 1/3 of exhaled air mixed with room air

Complete deflation of reservoir bag during

inspiration causes CO2 build up


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AEROSOL MASKS

Fits loosely over face or neck (tracheostomycollars)

Delivers 24% - 100% O2

Best for clients who do not tolerate other masks;

facial trauma & burnsDeliver high humidity

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NURSING CARE

Assess O2 needMonitor appropriateness of oxygen therapy

Document therapy response

Monitor O2 Sats, ABGs

Promote good oral hygiene

Rest, decrease environmental stimul

Support the anxious clieints

NURSINGCAREIN


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NURSING CARE IN

RESPIRATORY DISTRESSFowlers positionComplete a focus respiratory assessment

Promote adequate oxygenation: deep breathing &

supplemental oxygen

Promote airway clearance: coughing, suctioning

Stay with client

Decrease anxiety

QUESTION


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QUESTIONYou are caring for a client who had

abdominal surgery 24 hours ago. This

client has a 10yr old history of COPD.

hat inter!entions are necessary to

maintain a "atent airway####

conceopts 0f o2-co2.ppt_co0

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