OXYGENATION

RESPIRATORY
SYSTEM
The respiratory system is
responsible for the vital process of
breathing, which involves the
exchange of gases between the
body and the environment.
STRUCTURES:

Nose: The primary entry point for air. It

filters, warms, and moistens inhaled air.

Mouth: An alternate entry point for air,

especially during strenuous activity or
nasal congestion.

Pharynx (Throat): A common

passageway for both air and food.

Larynx (Voice Box): Contains the vocal

cords for sound production.

Trachea (Windpipe): A tube that

connects the larynx to the bronchi.
STRUCTURES:

Bronchi: Two main branches of the

trachea, leading to the left and right
lungs.

Bronchioles: Smaller branches that

further subdivide within the lungs.

Alveoli: Tiny air sacs at the end of the

bronchioles where gas exchange occurs.
STRUCTURES:

Lungs: The primary organs of

respiration, consisting of spongy tissue
containing millions of alveoli.

Diaphragm: A dome-shaped muscle

that separates the chest cavity from the
abdomen and plays a crucial role in
breathing.

Intercostal muscles: Muscles between

the ribs that assist in breathing.
FUNCTION OF THE
RESPIRATORY SYSTEM
• GAS EXCHANGE
⚬ Oxygen from inhaled air diffuses into the bloodstream through the
alveolar walls, while carbon dioxide, a waste product of cellular
metabolism, diffuses from the blood into the alveoli to be exhaled.

• RESPIRATION
⚬ The overall process of breathing, including inhalation (breathing in)
and exhalation (breathing out).

• PROTECTION
⚬ The respiratory system filters out dust, pollutants, and pathogens to
protect the delicate lung tissues.
FUNCTION OF THE
RESPIRATORY SYSTEM
• ACID-BASE BALANCE
⚬ The respiratory system helps regulate the body's pH by controlling
the amount of carbon dioxide in the blood.

• SPEECH
⚬ The larynx, with its vocal cords, enables the production of sound.

• SMELL
⚬ The olfactory receptors in the nasal cavity allow for the sense of
smell.
PROCESS OF BREATHING
AND GAS EXCHANGE
BREATHING (VENTILATION)
INHALATION:

During inhalation, the diaphragm contracts,

moving downward. Intercostal muscles
between the ribs contracts, pulling the ribcage
upwards and outwards.
This increases the volume of the chest cavity,
creating lower air pressure within the lungs.
Therefore, air from the outside, with its higher
pressure, flows into the lungs through the
airways.
PROCESS OF BREATHING
AND GAS EXCHANGE
BREATHING (VENTILATION)
EXHALATION:

During exhalation, diaphragm relaxes, moving

forward and intercostal muscle also relax,
moving the ribcage downwards and inwards.
This decreases the volume of the chest cavity,
increasing air pressure within the lungs.
Therefore, air is forced out of the lungs through
the airways.
PROCESS OF BREATHING
AND GAS EXCHANGE
GAS EXCHANGE
IN THE LUNGS:

Oxygen: Inhaled air reaches the alveoli (tiny

air sacs). Oxygen diffuses across the thin
alveolar-capillary membrane into the blood.

Carbon Dioxide: Carbon dioxide, a waste

product from the body's cells, diffuses from the
blood into the alveoli to be exhaled.
PROCESS OF BREATHING
AND GAS EXCHANGE
GAS EXCHANGE
IN THE TISSUES:

Oxygen: Oxygen-rich blood is transported by

the circulatory system to the body's cells.
Oxygen diffuses from the blood into the cells
for cellular respiration.

Carbon Dioxide: Carbon dioxide, produced by

cellular respiration, diffuses from the cells into
the blood.
PROCESS OF BREATHING
AND GAS EXCHANGE
TRANSPORTATION

Oxygen: Oxygen binds to hemoglobin in red

blood cells for transport to the body's tissues.

Carbon Dioxide: Carbon dioxide is transported

in the blood in three ways:
• Dissolved in the blood plasma
• Bound to hemoglobin
• As bicarbonate ions
TRANSPORTING OXYGEN AND CARBON
DIOXIDE TO AND FROM THE BODY
TISSUES
OXYGEN TRANSPORT
• Inhalation:
⚬ Air containing oxygen is inhaled through the nose or mouth.

• Gas Exchange:
⚬ In the lungs, oxygen diffuses from the alveoli (tiny air sacs) into the
bloodstream.

• Transportation:
⚬ Red blood cells, specifically hemoglobin within them, bind to oxygen.
These oxygen-rich red blood cells are then transported by the
circulatory system to all the body's tissues.
TRANSPORTING OXYGEN AND CARBON
DIOXIDE TO AND FROM THE BODY
TISSUES
CARBON DIOXIDE
TRANSPORT
• Cellular Respiration:
⚬ During cellular metabolism, cells produce carbon dioxide as a
waste product.
• Diffusion:
⚬ Carbon dioxide diffuses from the body's cells into the bloodstream.

• Transportation:
⚬ Carbon dioxide is transported in the blood in three main ways:
￭ Dissolved in the blood plasma
￭ Bound to hemoglobin
￭ As bicarbonate ions

• Exhalation:
⚬ The blood carrying carbon dioxide travels back to the lungs. In the
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
PHYSIOLOGICAL FACTORS
• Carbon Dioxide Levels:
⚬ Increased carbon dioxide in the blood stimulates
the respiratory center in the brain to increase
breathing rate and depth.

• Oxygen Levels:
⚬ Decreased oxygen levels in the blood can also
stimulate breathing, though to a lesser extent
than carbon dioxide.

• Blood pH:
⚬ Changes in blood pH, often due to imbalances in
carbon dioxide levels, significantly influence
breathing rate.
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
PHYSIOLOGICAL FACTORS
• Temperature:
⚬ Higher temperatures can increase metabolic rate
and oxygen demand, leading to increased
breathing.

• Exercise:
⚬ Physical activity significantly increases the body's
demand for oxygen and leads to a dramatic
increase in breathing rate and depth.

• Hormones:
⚬ Some hormones, such as epinephrine
(adrenaline), can increase breathing rate.
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
NEUROLOGICAL FACTORS
• Nervous System Control:
⚬ The respiratory center in the brainstem controls
the rhythm and depth of breathing.

• Brain Injuries:
⚬ Injuries to the brain or spinal cord can disrupt the
signals that control breathing.
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
ENVIRONMENTAL FACTORS
• Air Quality:
⚬ Pollutants, smoke, and allergens in the air can
irritate the airways and impair breathing.

• Altitude:
⚬ At high altitudes, the air has a lower oxygen
content, which can make breathing more difficult.

• Temperature and Humidity:

⚬ Extreme temperatures and humidity can affect
breathing comfort and efficiency.
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
LIFESTYLE FACTORS
• Smoking:
⚬ Smoking damages the airways and lungs,
significantly impairing respiratory function.

• Alcohol Consumption:
⚬ Excessive alcohol consumption can depress the
respiratory center.

• Drug Use:
⚬ Certain drugs, such as opioids, can slow or even
stop breathing.
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
DISEASES
• Respiratory Infections:
⚬ Conditions like pneumonia and bronchitis can
inflame the airways and impair gas exchange.

• Chronic Lung Diseases:

⚬ Conditions like asthma, chronic obstructive
pulmonary disease (COPD), and emphysema can
cause long-term damage to the lungs.

• Other Diseases:
⚬ Certain other diseases, such as heart disease and
neuromuscular diseases, can also affect
respiratory function.
FACTORS INFLUENCING
RESPIRATORY FUNCTIONS
AGE
• Aging:
⚬ Lung function naturally declines with age, leading
to decreased lung capacity and efficiency.
OXYGEN
THERAPY
Oxygen is a colorless, odorless, tasteless
gas that is essential for the body to
function properly and to survive.

Oxygen therapy is a medical treatment that

provides you with extra oxygen to breathe
in. It is also called supplemental oxygen.

Oxygen therapy is the administration of

oxygen at a concentration of pressure
greater than that found in the
environmental atmosphere.
PURPOSE OF
OXYGEN THERAPY
• To relieve dyspnea and prevent
hypoxemia (low level of oxygen in the
blood) and hypoxia (low level of oxygen
in cells):
⚬ The purpose is to increase oxygen
saturation in tissues where the
saturation levels are too low due to
illness or injury.

• To increase oxygenation in tissues:

⚬ Oxygen therapy aims to correct low
blood oxygen levels and support vital
bodily functions.
MAJOR CHARACTERISTICS OF
OXYGEN THERAPY

Supports
Oxygen is a Dry Gas COMBUSTION
explosion/will explode
• Humidify the oxygen COLORLESS or
with PNSS/sterile ODERLESS Gas
• Place: No Smoking
eater Sign
• Prone to leakage
• Perform: ORAL CARE • Check: Electrical

• Lubricate with water Devices

• Use: Cotton Fabric
base lubricant
• Do not use: Wool &
Silk promotes static
electricity
SOURCES OF OXYGEN

OXYGEN CYLINDERS

The oxygen cylinder is delivered with a

protective cap to prevent accidental force
against the cylinder outlet.

To release oxygen safety and at a

desirable rate, a regular is used.
SOURCES OF OXYGEN

OXYGEN CYLINDERS

A Reduction Gauge that shows

the amount of oxygen in the tank.

A Flow Meter that regulates the

control of oxygen in liters per
minutes.

Oxygen is moistened by passing it

through a Humidifier to prevent
the mucous membranes of the
respiratory tree from becoming
dry.
SOURCES OF OXYGEN

WALL OUTLET OXYGEN

The oxygen is supplied from a central

source through a pipeline.

Only a flow meter and a humidifier are

required.
 An "oxygen key" usually refers
to a special wrench or tool used to
open the valve on an oxygen
cylinder.
METHODS OF
OXYGEN
ADMINISTRATION
• Nasal Cannula • Oxygen Hood

• Simple Mask • Oxygen Tent

• Partial Rebreather Mask • Ambu Bag
• Non Rebreather Mask • Tracheostomy Collar

• Venturi Mask • T-piece

NASAL CANNULA

A nasal cannula or prongs is a simple and

commonly used medical device that
delivers supplemental oxygen to a patient.

It’s a thin, flexible tube with two prongs

that fit into the nostrils. The other end of
the tube connects to an oxygen source,
such as an oxygen tank or concentrator.

The cannula delivers a continuous flow of

oxygen through the nostrils. This is used
for low-medium concentration of oxygen
(24-44%).
 Limitations:
Advantages:
• Comfortable: • Limited oxygen delivery:
⚬ Generally well-tolerated by ⚬ Compared to other oxygen
most patients. Client able to delivery methods, nasal
talk and eat with oxygen in cannulas deliver lower
place. concentrations of oxygen.
• Convenient:
⚬ Allows for some mobility • Can dry out nasal passages:
and freedom of movement. ⚬ May cause nasal dryness
Easily used in a home or irritation in some
setting. patients.
• Easy to Use:
⚬ Relatively simple to apply
and adjust.
Nursing Interventions:

• Be alert for skin breakdown

over the ears and in the
nostrils
• Observe for mucosal dryness
• Check frequently that both
prongs are in clients nares
 SIMPLE OXYGEN MASK
A simple oxygen mask is a clear, flexible, plastic
mask that can be molded to fit over the
patient's nose and mouth. It has small holes on
the sides that allow exhaled air to escape. It is
held to the head with elastic bands. Some have
a metal clip that can be bent over the bridge of
the nose for a comfortable fit.

It delivers 35% to 60% oxygen. A flow rate of

6 to 10 liters per minute.

It has vents on its sides which allow room air

leak in at many places, thereby diluting the
source of oxygen.
Often, it is used when an increased delivery
of oxygen is needed for short periods
(less than 12 hours).
 Limitations:
• May cause discomfort:
Advantages: ⚬ Can feel stuffy or
claustrophobic for some
• Relatively easy to use: patients. Uncomfortable
⚬ Simple to apply and adjust. when eating of talking.
• May not be suitable for all
• Can deliver moderate levels of patients:
oxygen: ⚬ Not recommended for
⚬ Provides a higher patients who cannot
concentration of oxygen tolerate having their face
than a nasal cannula. covered.
Nursing Interventions:

• Monitor client frequently to

check placement of the mask.

• Secure physician’s order to

replace mask with nasal
cannula during meal time.
 PARTIAL REBREATHER
MASK
The mask comes with a reservoir bag that must
remain inflated during both inspiration and
expiration.

It collects part of the patient’s exhaled air.

It is used to deliver oxygen concentrations up to

80%
The oxygen flow rate must be maintained at a
minimum of 6 liters per minute to ensure that
the patient does not re-breathe large amounts
of exhaled air.

The remaining exhaled air exists through vents.

Advantages:
Nursing Interventions:
• Delivers higher oxygen
concentrations:
• Set flow rate so mask remains
⚬ Compared to simple face
two-thirds full during
masks.
inspiration.
• Less restrictive:
• Keep reservoir bag free of
⚬ Allows for some rebreathing,
twists or kinks.
which can be more
comfortable for some
patients.

Limitations:
• Requires tight seal:
⚬ Eating and talking is difficult and
uncomfortable.
 NON REBREATHER MASK
This mask provides the highest concentration of
oxygen (95-100%) at a flow rate of 6 to 15 liters
per minute.

It is similar to the partial rebreather mask

except two one-way valves prevent
conservation of exhaled air.
The bag has an oxygen reservoir.

When the patient exhales air the one-way valve

closes and all expired air is deposited into the
atmosphere, not the reservoir bag.

In this way, the patient is not re-breathing

any of the expired gas.
Limitations:

• Risk of Suffocation:
⚬ If the oxygen supply runs out or is interrupted, the patient
cannot breathe in any air from the room, leading to
potential suffocation.
• Uncomfortable for Long-Term Use:
⚬ Can be uncomfortable and claustrophobic for extended
periods.
• Requires Constant Monitoring:
⚬ Must be closely monitored by medical professionals to
ensure proper oxygen delivery and prevent complications.
• Not Suitable for All Patients:
⚬ Not appropriate for patients who cannot maintain their
own airway.
 Nursing Interventions:
Advantages:
• Maintain flow rate so the
• Delivers High Oxygen reservoir bag collapses only
Concentrations: slightly during inspiration.
⚬ Can provide up to 90%
oxygen concentration, • Check that valves and rubber
crucial for patients with flaps are functioning properly
critically low blood oxygen (open during expiration)
levels.
• Monitor oxygen saturation
• Rapid Oxygen Delivery: with pulse oximeter
⚬ Quickly increases blood
oxygen levels in emergency
situations.
VENTURI MASK
It is high-flow oxygen delivery device.
Oxygen from 40-50% at a liter flow of
4 to 15 liters per minute.

The mask is constructed so that there is a

constant
flow of room air blended with a fixed
concentration of oxygen.

Designed with wide – bore tubing and

various color – coded jet adapters.

Each color code corresponds to a precise

oxygen concentration and a specific liter flow.

It is used primarily for patients with

chronic obstructive pulmonary disease.
Limitations:

• Limited Flexibility:
⚬ Changing the oxygen concentration requires changing the
color-coded venturi nozzle, which can be time-consuming.
• Can be Uncomfortable:
⚬ The mask itself can be uncomfortable for some patients,
and the high flow rates can dry out the mucous
membranes.
• Requires Precise Flow Rates:
⚬ The Venturi effect relies on specific oxygen flow rates to
achieve the desired concentration. If the flow rate is
incorrect, the FiO2 will be inaccurate.
Advantages:
• Precise Oxygen Delivery:
⚬ Delivers a very specific and Nursing Responsibilities:
consistent concentration of
oxygen by mixing oxygen with
• Requires careful monitoring to
room air. This is crucial for
verify FiO2 at flow rate
patients who require a precise
ordered.
FiO2 (fraction of inspired
oxygen).
• Less Dependent on Patient's • Check that air intake valves
Breathing: are not blocked.
⚬ The oxygen concentration
delivered is less affected by
the patient's breathing rate
and depth compared to some
other masks.
OXYGEN HOOD

An oxygen hood is used for babies; it is

a clear plastic enclosure that fits over
the infant's head. The hood delivers
warmed and humidified oxygen to the
infant. Helps infants with respiratory
problems breathe more easily by
providing a consistent supply of
oxygen.
OXYGEN HOOD
An oxygen tent consists of a canopy placed
over the head and shoulders, or over the entire
body of a patient to provide oxygen at a higher
level than normal.
It consisted of a clear plastic enclosure that
was placed over the patient's head and
shoulders or sometimes the entire body. It can
envelop the patient’s bed with the end sections
held in place by a mattress to ensure that the
tent is airtight. The enclosure often has a side
opening with a zipper. Oxygen was introduced
into the tent, creating an environment with a
higher concentration of oxygen than the
surrounding air.
Limitations:

• Less efficient:
⚬ Modern oxygen delivery methods, such
as nasal cannulas, face masks, and high-
flow nasal cannulas, are generally more
effective and comfortable for patients.
• Safety concerns:
⚬ Oxygen tents can pose fire hazards due
to the high concentration of oxygen
within the enclosure.
ARTIFICIAL MANUAL
BREATHING UNIT BAG OR
BAG VALVE MASK
VENTILATION
It is a hand-held device commonly used to
provide positive pressure ventilation to
patients who are not breathing or not
breathing adequately.

It consists of a flexible, self-inflating bag that

is squeezed by the rescuer. A face mask is
placed over the patient's mouth and nose to
create a seal. A valve controls the flow of air,
allowing air to be expelled from the bag into
the patient's lungs and preventing air from
TRACHEOSTOMY
COLLAR/MASK
It's a strap or band that wraps around the
neck and secures the tracheostomy tube in
place. It prevents the tube from moving or
becoming dislodged. It is directed into
trachea.

It provides accurate FiO2. Oxygen flow rate is

8 to 10 liters. This provide good humidity,
comfortable and more efficient.
T-PIECE

A T-piece is a medical device used in

respiratory care, particularly during weaning
from mechanical ventilation. It's a T-shaped
connector that attaches to the endotracheal
tube or tracheostomy tube.

Oxygen is delivered through one arm of the

"T," while the other arm allows for the patient
to exhale.
T-PIECE
Indication:

• Weaning from mechanical ventilation:

⚬ Helps patients gradually transition from
full ventilator support to spontaneous
breathing.
⚬ Allows for controlled trials of
spontaneous breathing while still
providing supplemental oxygen.
• May be used for other purposes, such as
delivering humidified air or medications
to the airways.
SIDE EFFECTS OF
OXYGEN
ADMINISTRATION
• Oxygen Toxicity

• Retroletal Fibroplasia

• Absorption Atelectasis

• Drying of the Mucus

Membrane
• Infection
 RETROLETAL
OXYGEN TOXICITY
FIBROSIS
It is a condition that occurs due to
High levels of oxygen can damage
the inspiration of a high
the developing blood vessels in the
concentration of oxygen for a
retina of premature infants.
prolonged period of time.
This damage leads to abnormal blood
vessel growth (neovascularization)
Oxygen concentration greater than
behind the lens of the eye.
50% over 24 to 48 hours can cause
These abnormal vessels can leak
pathological changes in the lungs.
fluid, scar tissue, and even detach
the retina, leading to vision loss and
blindness.
ABSORPTION
ATELECTASIS

During 100% oxygen delivery, nitrogen in

alveoli is washed out and replaced by
oxygen.

In contrast to nitrogen, oxygen is

extremely soluble in blood and diffuses
very quickly into the pulmonary
vasculature, so that not enough gas is left
in the alveoli to maintain patency, and the
alveolus collapses; this is known as
absorbtion atelectasis.
SAFETY PRECAUTION OF
OXYGEN
ADMINISTRATION
• Avoid naked flames near the oxygen cylinder.
• Put a NO SMOKING sign at the entrance of the ward
and near the patient bed to warn others.
• Do not use oil on the oxygen cylinder. Oil can ignite if
exposed to oxygen.
• Do not use electrical gadgets or any article that can
cause sparks near the oxygen cylinder.
• Do not give oxygen to a hyperventilated patient.
• Keep oxygen cylinders in a dry and cool place.
SAFETY PRECAUTION OF
OXYGEN
ADMINISTRATION
• Mark the oxygen cylinder to indicate whether full or
empty.
• Use only carriers with wheels to transport the oxygen
cylinder, do not roll the oxygen cylinder.
• Oxygen must only be administered at the rate and
percentage prescribed.
• Do not adjust the flow meter until instructed or
prescribed by the physician.
• Encourage or assist the patient to move about in bed
to prevent hypostatic pneumonia or circulatory
difficulties.
NURSING CONSIDERATION

1. Assess for HYPOXIA

a. Early Hypoxia - increase in PR, RR,
and BP due to compensation =
Restlessness
b. Late Hypoxia - decrease in PR, RR,
and BP = Cyanosis
2. Verify Doctor’s Order
⚬ 2-3 LPM - independent
⚬ more than 3 LPM - dependent
3. Position Patient in Semi-Fowler
4. Regulate Oxygen Flow accurately
COLOR OF THE TANKS

YELLOW compressed air

BROWN helium

GREEN oxygen

GRAY carbon dioxide

BLACK nitrogen
BLUE nitrous oxide or
RED laughing gas
fire extinguisher
THANK YOU,
DEAR
NURSES!