MODULE NO.

2: CONCEPT OF OYGENATION
OXYGEN THERAPY
A. Purpose: Reverse hypoxia
B. Goal: Inc. 02 level
J. Adverse Effect: Irreversible blindness
aka retrolental floraplatia or retinopathy
prematurity

C. Position: High fowlers COPD

(R: Inc. lung expansion) - Low at 2 to 3lpm
- Venturi mask
D. Diet: NPO or Small frequent feeding
4 Wall Outlet Supplemental Therapy
E. Clothing: Cotton-based
G O2
F. Toys: No battery-operated toys and extra
devices
Nitrogen oxide or
G. Precaution: “No smoking” sign (bed, B Laughing gas
container, door)

H. Devices: Y Medical air

 Pulse oximeter – 95% to 100% (finger,
earlobe, forehead)
**Do not expose to direct sunlight Suction
W
 Incentive spirometer – Inc. alveolar
expansion
 Humidifier – moisture

I. O2 Delivery System
a. Low flow – nasal cannula
b. Moderate flow – venturi mask
c. High flow – face mask
 MODULE NO. 2: CONCEPT OF OYGENATION
SUCTIONING
- Remove pulmonary secretions or excess Infant 3 to 5 50 to 95
fluids
F. Suction Types
A. Priority: Hyper-oxygenate before and after Oral Nasal
Tracheal
(R: prevent hypoxia) 5 to 10
Duration 10 to 15 secs
secs
B. Position: Rest 2 to 3
20 to 30 secs
 Conscious: Semi-fowlers Period mins
 Unconscious: Side lying Length 3 to 5 inch 2 to3 inch
(R: prevent aspiration) Clean Sterile
Lubricant KY Jelly
water H2O/NSS
**Apply suction upon withdrawal
(R: prevent trauma)

C. Technique: Sterile
 Dominant hand – Sterile
 Non-Dominant hand – Clean

D. Catheter Size
Fr.
Adult 12 to 18
Child 8 to 10
Infant 5 to 8

E. Suction Pressure (mmHg)

Portable Wall (Thick)
Adult 10 to 15 100 to 120
Child 5 to 10 95 to 110
MODULE NO. 2: CONCEPT OF OYGENATION
 MODULE NO. 2: CONCEPT OF OYGENATION
 Outer cannula
CHEST PHYSIOTHERAPY C. Solution:
A. Purpose: Displace the phlegm
 Hydrogen peroxide (half strength)
**Bronchial easiest
 NSS
D. Principles:
B. When: Before meals
1. Cleansing inner cannula
**If after meals: 2 to 3 hrs. after
a. Unlock it counterclockwise
b. Immerse to hydrogen peroxide: use soft sterile tube brush
C. Contraindication:
c. Immerse to NSS (10 secs)
D. Components:
d. Re-insert and lock it clockwise
a. Percussion – “cup/tap” (hollow sounds)
2. Changing of tie
b. Vibration – “fine and shaky motion” (exhalation)
**Place new tie before removing the old tie
c. Postural drainage
(R: prevent dislodgement)

1. Apex – upright leaning forward

2. Base – T-berg position
(R: Inc. ICP – restlessness, Dec. LOC)
3. R Lung – Left side lying
4. L Lung – Right side lying

TRACHEOSTOMY CARE
A. Technique: Sterile
B. Parts:
 Obturator – serves as guide upon insertion of outer cannula
 Inner cannula – can be remove for cleansing
 MODULE NO. 2: CONCEPT OF OYGENATION
CHEST TUBE
THORACOTOMY (CTT)
- Pneumothorax, hemothorax, pleural  Teflon dressing
effusion  Dry dressing
b. Bottle
A. Assessment: Auscultation (diminished breath  Nurse can reconnect
sounds)  Immersed in sterile water
B. Parts: 3-way bottle system 4. Broken bottle
a. Clamping 10 to 20 secs.
(R: prevent tension pneumothorax)
b. Immersed to sterile water (best
answer)
1st 5. Transferring patient with CIT
Nearest a. Bottles must be lower than the chest
2nd 3rd
to the (R: facilitates continuous drainage)
patient
6. Fluctuation (2nd bottle: Normal)
Drainage/ Water Suction - Oscillation, vacillation
collection seal a. Check for system: kink, coil tubes,
chamber obstruction, or dislodgement
b. Check for possibility of lung
expansion
 RR Report to
C. Principles: physician
 DOB
1. Bubbles on the 3rd bottle
 Breath sounds
Normal: continuous
**Confirmatory: Chest x-ray
2. Bubbles on the 2nd bottle
7. Removal
Normal: Intermittent (cough, sneezes, or
a. Profuse bleeding – reinforced then
move)
report to physician
**Continuous: air leak
b. Instruct client to: Valsalva maneuver
3. Dislodge tube
(R: Inc. intrathoracic pressure)
a. Patient
 Cover with vaselined gauze