NCMA113 LEC & LAB: OXYGENATION (MA’AM GARCIA)

OXYGENATION  Gas Exchange – intake of oxygen and the excretion of carbon

dioxide.
During Inspiration
- Diaphragm descends in the abdominal cavity causing lungs to
have negative pressure and;
- (-) intrapulmonary pressure because of this it will;
- Air draws from greater pressure into lesser pressure (to
equalize the pressure with the atmospheric pressure)
- Once it’s inside the lungs air will move to;
 Trachea
 Bronchi
 And alveoli

o Nose – serves as humidifier including warmth’s and filters the

air as we breath in. then diff. sinuses which provide resonance Alveolar-Capillary Gas Exchange
the sounds we produce. - Diffusion of oxygen and carbon dioxide between the alveoli
o Pharynx – further subdivided to nasopharynx, oropharynx, and and pulmonary capillaries.
laryngopharynx. - Air diffuses into capillaries.
o Larynx – also known as the voice box.
o Epiglottis – helps prevent developing aspiration because it
stays open during the time of breathing and during the time of
swallowing it closes.
o Lungs – consist of left and right lung. The smaller is the left
lung because it consists of two lobes only. The right lung has
three lobes.
Alveoli Transport of oxygen and Carbon Dioxide
- Smallest functional unit of respiratory system. - The oxygen will be transported from the lungs to the tissues so
- Alveolar cells: that it will be able to oxygenate the diff. tissues, or the cells of
a) Type I Pneumocyte the tissues and carbon dioxide will be transported from the
- Squamous and extremely thin. tissues back to the lungs and outside the body.
- Cover – 95% of alveolar surface. Diaphragm and intercostal muscles relax
- Involved in gas exchange. - During the end of inhalation, the lung will be recoiled, when
b) Type II Pneumocyte the lungs recoiled the pressure of the lungs will become higher
- Granular and roughly cuboidal. than the atmospheric pressure.
- Cover – 5% of alveolar surface. - The air inside the lungs will move from the lungs going
- Secrete pulmonary surfactant. outside the body.
- This is important in reduction of surfaces tension of
the lungs to prevent the development of lung
collapsed.

Respiratory Process
 Ventilation or breathing
- the movement of the air into and lungs.
- Process of inhalation and exhalation.
 Respiration – process of gas exchange between individual
and environment (Udan, 2004)

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 FUNDAMENTALS OF NURSING PRACTICE LEC & LAB: WEEK 4 – OXYGENATION (MA’AM GARCIA)

Types of Respiration Inspiratory Reserve Volume (IRV)

 External respiration - is gas exchange with in external - Extra air inhaled beyond tidal volume. Breathing more than
environment and usually happens in alveoli in the lungs. the usual
 Internal Respiration – took place in the cellular level so that - 3000 ml
involve the gas exchange bet. the blood and the body cells. - Halimbawa kapag umakyat ka ng 50th floor ng building
kailangan mo ng extra air
Expiratory Reserve Volume (ERV)
- Extra air exhaled beyond the tidal volume.
- 1,100ml
- The amount of extra air that can be exhaled beyond the tidal
volume.
Residual Volume (RV)
- Remains in the lungs after forceful exhalation
- 1,200 ml
- Ito yung iniiwan ng lungs mo kahit galing ka sa forceful
exhalation.
Lung Capacity
- Total amount of air that your lungs can hold
- Total Lung Capacity
 Total of volumes (TV + IRV + ERV+ RV)
 5,800 ml
Muscle
- Normal breathing, we used;
1) Rib Muscle
2) Diaphragm
- They are the one to contract and relaxes for inhalation and
exhalation to happen.
- We do it for 16 times.
- RR – around 14 to 20 cycles in a minute but in other book the
RR is around 16-20 cycles in a minute
- Eupnea – Normal Breathing Pattern
Acessory Muscle
- Inspiration
 Sternocleidomastoid
 Scalene Muscle
- Expiration
Lung Volume & Lung Capacity
 Abdominal
 Lung Volume – volume of gas in lungs during respiratory
 Internal Intercostal
cycle also called respiratory volume
 Tidal Volume – (V or TV)
- Air w/ each normal breathing Respiratory Control Centers
- 500ml or 5ml – 10ml /kg  Medulla Oblongata – sends signals to muscles. (innervates
- Volumes – depends on the gender and age of the client respiratory muscles this are rib muscles and diaphragm)
 Pons – controls rate/no. of times of breathing

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 FUNDAMENTALS OF NURSING PRACTICE LEC & LAB: WEEK 4 – OXYGENATION (MA’AM GARCIA)

Factors that Influence Respiratory Function Nursing Diagnoses

 Age (in children mas mabilis ang RR nila compare to adults)  Ineffective breathing pattern – ventilation not adequate. (so
 Environment (living in high altitude mas thin air so mas nagging tachypnea or bradypnea)
madami ang kanilang rr including depth of their breathing  Ineffective Airway Clearance – inability to clear obstructions.
other is work environment like working with asbestos mas (ex. Pt. have sticky phlegm)
prone mag develop ng respiratory disease)  Impaired Spontaneous Ventilation – not able to maintain
 Lifestyle (those who are into smoking is usually affected) breathing.
 Health status (problems connected to the spinal column will  Activity Tolerance – insufficient energy. (s/s: weakness,
affect the inervation of respiratory muscles or anemia will dec. fatigue)
the ability of our body to transport o2)  Risk for Activity Intolerance – possible insufficient energy.
 Medications (dec. respirations like sedatives used in surgery)  Impaired Gas Exchange – Alveolar-capillary membrane
 Stress (may make the person to hyperventilate) changes.

Abnormal Respiratory Patterns

 Tachypnea (rapid rate) – more than 20 breaths per minute.
Seen in patient with fever, metabolic acidosis hypoxemia and
in pain.
 Bradypnea (abnormally slow rate) – less than 12-14 breaths.
Seen in pt. who took morphine or sedatives.
 Apnea (cessation/ absence of breathing)
 Kussmaul’s breathing- deep rapid and labor breathing
usually seen in pt. with diabetic and ketoacidosis
 Cheyne-Stokes Respirations- seen in pt. with drug overdose
or increased intracranial pressure which is characterized by
gradual inc. and dec. and there are few sec. of apnea
 Biot’s Respiration – shallow breathing and interrupted by
apnea. Seen in pt. with central nervous system disorder.
 Hypoxemia – reduced oxygen levels in the blood. (so konti
lang makakarating sa parts ng body)
 Hypoxia – low levels of oxygen in the tissues of your body.

Impaired Oxygenation
Early s/s of Hypoxia
 Restlessness (agitation)
 Tachypnea
 Increased depth and rate of respiration
 Slight increase in systolic BP
Note: prior to lumala case ng pt. agapan na dpt put the pt. in semi
fowlers pos. suction, and oxygenation.
Late s/s of Hypoxia
 Decreased respiratory rate (bradypnea) bcs of the fatigue
happening in the respiratory muscles
 Bradycardia
 Dyspnea, retractions
 Decreased systolic BP
 Cyanosis
Note: during this marereverse ung early s/s

Caring for Patients with Impaired Oxygenation

- Assessing respiratory status:
 Color of skin and mucous membranes
 Respiratory effort
 Cough (dry or productive?)
 Chest appearance
 Oxygenation status
 Oxygen saturation

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