CHAPTER 1

INTRODUCTION

A. Background
Oxygenation is the fulfillment of oxygen (O2) requirements. The physiological
needs of oxygenation are basic human needs that are used for the continued
metabolism of the body's cells, to maintain its life, and for the activities of various
organs or cells. If more than 4 minutes people do not get oxygen it will result in brain
damage that can not be repaired and usually the patient will die.

B. Problem Formulation
1. What is the definition of oxygenation needs?
2. What bodily systems play a role in oxygenation needs?
3. How does the process of oxygenation occur together?
4. What factors influence the need for oxygenation?
5. What are the types of respiratory and lung function measurements?
6. What is the nursing process for the problem of oxygenation needs?

C. Purpose
1. To find out things related to oxygenation needs
2. To find out the type of breathing and lung function measurements
3. To find out the nursing process in the problem of oxygenation needs

D. WritingThe
Methodmethod used in the preparation of this paper is the study of literature.
Literature study is a method of collecting data by searching, gathering, and studying
material from books and other information media in this regard relating to oxygenation
needs.
 CHAPTER II
DISCUSSION

A. Needs

OxygenOxygen plays an important role in all functional bodily processes. The

absence of oxygen will cause the body to functional decline or even cause death.
Therefore, the need for oxygen is the most important requirement and is very vital for
the body.
Meeting the needs of oxygen is inseparable from the functional condition of
the respiratory system. If there is a disruption in one of the respiratory system organs,
the oxygen demand will experience interference. Often individuals are not aware of
the importance of oxygen. The process of breathing is considered as something
mediocre. Many conditions cause a person to experience a disruption in fulfilling
oxygen demand, such as a blockage in the respiratory tract. In this condition,
individuals feel the importance of oxygen.

B. A Body System That Roles in Oxygenation Needs of

the Upper Respiratory Tract:
1. Nose, the process of oxygenation begins with the entry of air through the
nose.
2. esophagus.
3. Larynx, is the respiratory tract after the pharynx.
4. Epiglottis, a cartilage valve that is in charge of closing the larynx when the
process closes.
Lower respiratory tract:
1. Trachea, is a continuation of the larynx to approximately the height of the
fifth thoracic vertebrae.
2. Bronchhus, is a continuation of the trachea branching into the right and left
bronchus.
3. Bronchiole, is the branching channel after the bronchus.
4. Alveoli, are air sacs where oxygen is exchanged with carbon dioxide.
 5. Lung (Pulmo), Lungs are the main organs in the respiratory system.
C. Oxygenation Process
1. Ventilation
Is the process of oxygen in and out of the atmosphere into the alveoli or from
the alveoli into the atmosphere. The process of ventilation is influenced by several
things, namely the difference in pressure between the atmosphere and the lung, the
higher the place the lower the air pressure, and vice versa, the lower the place the
higher the air pressure.
The effect of the next ventilation process is complienci and recoil. Complience
is the lung's ability to expand. while recoil is the ability of CO2 or contraction of the
narrowed lungs. The respiratory center, namely the medulla oblongata and the pons,
can be affected by ventilation. This ventilation process is influenced by several factors:
a. The presence of oxygen concentration in the atmosphere
b. The existence of good airway conditions The
c. existence of the ability of the thorax and alveoli in the lungs in carrying out
expansion or flat growth.
2. Gas Diffusion Gas
diffusion is an exchange between dialveoli oxygen and pulmonary capillaries
and co2 in capillaries with alveoli. This exchange process is influenced by several
factors, namely the extent of the lung surface, the thickness of the respiration
membrane or permeability which consists of alveoli and interstitial epithelium (both
can affect the diffusion process in the event of a thickening process). The difference
in pressure and O2 concentration (this is where O2 from the alveoli enters the blood
because the O2 pressure in the alveoli cavity is higher than the O2 pressure in the
pulmonary venous blood, entering the blood diffusionly).
3. Gas Transplantation Gas
transportation is the process of distributing capillary O2 to body tissues and
body tissue Co2 to capillaries. Gas transformation can be influenced by several factors,
namely cardiac output (cardiac output), vascular conditions, exercise (exercise),
comparison of blood cells with overall blood (hematocrit), as well as erythrocytes and
Hb levels.
D. Types of Breathing
 1. External Breathing External
breathing is the process of entry of O2 and the release of CO2 from the body,
often referred to as normal breathing. This breathing process starts from the entry of
oxygen through the nose and mouth when breathing, then oxygen enters through the
trachea and bronchial tubes into the alveoli, then oxygen will penetrate the membrane
which will be bound by Hb red blood cells and carried to the heart. After that, red
blood cells are pumped by arteries throughout the body to then leave the lungs at 100
mmHg oxygen pressure.
2. Internal Breathing Internal
breathing is a process of gas exchange between tissue cells and surrounding
fluid which often involves the process of all hormones including catecholamine
derivatives can dilate the respiratory tract.

E. Lung Function Examination With a SpirometryTool

Respiration(Breathing or Ventilation) as a cycle of inspiration and expiration.
Normal adult respiratory rate ranges from 12-16 times per minute carrying about 5
liters of air in and out of the lungs. Volumes lower than the normal range often indicate
pulmonary system malfunctions. Lung volume and capacity are measured by means
of a spirometer or spirometry, while the results of the recording are called spirograms.
The air that exits and enters the respiratory tract during inspiration and
expiration of 500 ml is called the tidal volume, while the tidal volume varies from
person to person depending on the time of measurement. An average adult of 70%
(350 ml) of tidal volume can significantly reach the bronchioles, alveolar ducts, alveoli
bags and alveoli that are active in the gas exchange process. While the remaining 30%
(150 ml) settled in the loss space (anatomic dead space).
The total volume of air exchanged in one minute is called the minute volume
of respiration (MVR) or also commonly called the minute vantilation. This MVR is
obtained from the product of tidal volume and the frequency of normal breathing per
minute. The average MVR of 500 ml tidal volume of 12 times per minute breathing is
6000 ml / min.
 Respiratory volumes that exceed 500 ml tidal volume can be obtained by taking
deeper breaths. This addition of air is commonly called the Inspiratory reserve volume
of 3100 ml from the previous tidal volume, so that the total tidal volume is 3600 ml.
Even though the lung is empty after the maximum expiration phase, the lung
actually has residual air called residual volume which keeps the lungs from collapsing,
the amount of residual volume is around 1200 ml.
Here's how to examine the vital lung with a spirometry device:
a. Prepare a spirometry
b. device Turn on the device first by pressing the ON button. Enter data such
as age, sex, TB, BB.
c. Then insert the mouthpiece in the spirometry device into his mouth and
cover the nose with a nose clip.
d. To regulate breathing, breathe calmly before examining.
e. Press the start button when ready to start the measurement.
f. Start with calm breathing until an order from the device for maximum
expiration (uninterrupted) arises. When done correctly it will come out data
and curves on the spirometry monitor screen.
g. Then repeat the measurement by continuing deep inspiration and maximum
expiration.
h. After completing the mouthpiece, check the data and the curve then
proceed to print the recording (press the print button on the spirometry
tool).

F. Factors Affecting Oxygen

Needs The body's need for oxygen is not constant, at any time the body requires
a lot of oxygen, for some reason. The need for oxygen in the body is influenced by
several factors, including the environment, exercise, emotions, lifestyle and health
status.
1. Environment
In a hot environment the body responds to the occurrence of peripheral arteries
vasodilation, so that much blood flows to the skin. This results in a lot of heat released
through the skin. Such a response causes cardiac output to increase and oxygen
demand increases. Conversely in a cold environment, blood vessels experience
constriction and decreased blood pressure thereby reducing the work of the heart and
oxygen demand.
The influence of the environment on oxygen is also determined by the height
of the place. In high places the barometer pressure will drop, so the oxygen pressure
also drops. The implication, if someone is at a high place, for example at an altitude
of 3000 meters above sea level, then alveoli oxygen pressure decreases. This indicates
little oxygen in the lungs. Thus, in high places the oxygen content is reduced. The
higher a place, the less oxygen content, so that someone who is at a high place will
experience lack of oxygen.
In addition, oxygen levels in the air are also affected by air pollution. The air
is inhaled in an air polluted environment, the oxygen concentration is low. This causes
the oxygen demand in the body is not met optimally. The body's response to the
environment of air pollution includes sore eyes, headaches, dizziness, coughing and
feeling suffocated.
2. Exercise
Physical exercise or increased activity can increase heart rate and respiration
rate so that the need for oxygen is higher.
3. Emotions
Fear, anxiety and anger will accelerate the heart rate so that oxygen demand
increases.
4. Lifestyle
Smoking will affect a person's oxygenation status because smoking can worsen
coronary artery disease and arterial blood vessels. Nicotine in cigarettes can cause
vasoconstriction of peripheral arteries and coronary arteries. As a result, blood supply
to the tissue decreases.
5. Health Status
In healthy people, the cardiovascular system and the respiratory system
function properly so that they can meet the body's oxygen needs adequately.
Conversely, people who have heart disease or respiratory disease can experience
difficulty in fulfilling the body's oxygen needs.
G. Disorders of Oxygenation
 Problems in terms of meeting the needs of oxygen can not be separated from
the disruption that occurs in the respiratory system both at the anatomy and
physiological organs of respiration. Problems in fulfillment can be caused by
interference with other body systems, for example the cardiovascular system.
Disturbances in the respiratory system can be caused by, among others,
inflammation, obstruction, trauma, cancer, degenerative and others. This disruption
will cause the body's oxygen needs not to be adequately met. Broadly speaking,
respiratory disorders are grouped into three namely rhythm / frequency breathing
disorders, respiratory insufficiency and hypoxia.
a. Respiratory rhythm / frequency of respiratory
1. rhythm disorders include:
a) Cheyne-stokes breathing, which is a breathing cycle whose amplitude
is initially shallow, increasing and then decreasing and stopping. Then
breathing begins again with a new cycle. This type of breathing usually
occurs in clients of congestive heart failure, increased intracranial
pressure, drug overdose. But physiologically, this type of breathing is
mainly found in people at an altitude of 12,000-15,000 feet above sea
level and in infants while sleeping.
b) 'Biot' breathing is breathing similar to Cheyne-stokes breathing, but the
amplitude is even and accompanied by apnea. This respiratory state is
sometimes found in inflammation of the lining of the brain.
c) 'Kussmaul' respiration, namely breathing, whose number and depth
increase often exceeds 20 times / minute. This type of breathing can be
found in clients with metabolic asiidosis and kidney failure.
2. Impaired respiratory frequency
a) Tachypnoea / hyperpnea, which is a breathing frequency whose number
increases above the normal pernapasa frequency.
b) Bradipnea, which is the opposite of tachypnea in which the amount of
respiratory fermentation decreases below normal breathing frequency.
b. Respiratoryrespiratory
insufficiency Causes ofinsufficiency can be divided into three main groups,
namely:
 1. Conditions that cause hypoventilation of the alveoli, such as:
a) paralysis of respiratory muscles, for example in poliomyelitis, cervical
transection.
b) Diseases that increase ventilation work, such as asthma, emphysema,
tuberculosis and others.
2. Abnormalities that reduce lung diffusion capacity:
a) Conditions that cause the diffusion surface area to be reduced, for
example lung tissue damage, tuberculosis, cancer and others.
b) Conditions that cause thickening of the respiratory membrane, for
example in pulmonary edema, pneumonia, and others.
c) Conditions that cause abnormal ventilation and perfusion ratios in some
parts of the lung, for example in pulmonary thrombosis.
3. Lung conditions that cause the disruption of oxygen transport from the
lungs to the tissues, namely:
a) Anemia in which the reduced amount of total hemoglobin available for
oxygen transport.
b) Carbon dioxide poisoning where most of the hemoglobin becomes
unable to carry oxygen.
c) Decreased blood flow to tissues caused by low cardiac output.
c. Hypoxia
Hypoxia is a lack of oxygen in the tissues. This term is more appropriate than
anoxia. Because, rarely happens there is no oxygen at all in the tissue. Hypoxia can be
divided into four groups namely hypoxemia, hypokinetic hypoxia, hypoxia
overventilation and histotoxic hypoxia.
1. Hypoxemia
Hypoxemia is a lack of oxygen in arterial blood. Divided into two types,
namely hypotonic hypoxemia (anoxic anoxic) and isotonic hypoxemia (anoxic
anemic). Hypotonic hypoxemia occurs where arterial oxygen pressure is low because
of carbon dioxide in high blood pressure and hypoventilation. Isotonic hypoxemia
occurs where oxygen is normal, but the amount of oxygen that can be bound by
hemoglobin is small. This is in the condition of anemia, carbon dioxide poisoning.
2. Hypoxia Hypokinetics (stagnate anoxia / anoxia bendun)
 Hypokinetic hypoxia that is hypoxia that occurs as a result of a dam or
blockage. Hypokinetic hypoxia is divided into two types, namely ischemic hypokinetic
hypoxia and congestive hypokinetic hypoxia. Ischemic hypokinetic hypoxia occurs
wherein the lack of oxygen to the tissue is caused by a decrease in blood supply to the
tissue due to narrowing of the arteries. Congestive hypokinetic hypoxia results from
excessive or abnormal accumulation of blood, both local and general, which causes
the supply of oxygen to the tissues to be disrupted, resulting in a lack of oxygen.
3. Hypoxia overventilation Hypoxia
overventilation is hypoxia that occurs due to excessive activity so that the
ability to supply oxygen is lower than its use.
4. Histotoxic hypoxia Histotoxic
hypoxia is a condition in which blood in the capillary tissue is sufficient, but
the tissue cannot use oxygen because of the influence of cyanide poison. This results
in oxygen returning in venous blood in more quantities than normal (venous blood
oxygen increases).
H. Nursing Problems Associated with oxygen demand
1. Ineffective airway

This nursing problem illustrates the condition of the airway that is not clean,
for example due to blockages, congestion of secretions, narrowing of the airway due
to bronchial spasm and others.

2. Ineffective breathing pattern.

The ineffective breathing pattern is a condition where the breathing pattern, ie

respiration and expiration, shows abnormal. The reason could be due to neoromuscular
weakness, a blockage in the trachea-bronchial, anxiety and others.

3. Disruption of gas exchange Disruption of gas

exchange is a condition where there is an imbalance between oxygen inhaled

with carbon dioxide released at the gas exchange between alveoli and capillaries. The
cause can be due to alveolar membrane changes, anemia conditions, disease processes
and others.

4. Decreased tissue perfusion

 Is a condition where cells lack a supply of nutrients and oxygen. The cause can
occur due to the condition of hypocolemia, hypervolemia, carbon dioxide retention,
decreased cardiac output and etc.

5. Activity intolerance

Is a condition where a person has decreased ability to carry out their activities.
The reason is because of the imbalance between oxygen and oxygen demand, the
resulting energy production decreases and others.

6. Changes in sleep patterns

Disorders of oxygen demand can result in disturbed sleep patterns. Difficulty

in breathing (shortness of breath) causes a person can not sleep at regular hours of
sleep. Changes in sleep patterns can also occur due to anxiety with the disease.

7. Risk of cerebral ischemia

Disruption of oxygenation results in reduced blood supply to the brain. This is

caused by decreased cardiac output, reduced blood flow to the brain, impaired brain
perfusion, and others. As a result, the brain lacks oxygen so there is a risk of brain
tissue damage.
 CHAPTER III
CLOSING

A. Conclusion
Oxygen plays an important role in all functional bodily processes. The absence
of oxygen will cause the body to functional decline or even cause death. Therefore, the
need for oxygen is the most important requirement and is very vital for the body.
Meeting the needs of oxygen is inseparable from the functional condition of the
respiratory system. If there is a disruption in one of the respiratory system organs, the
oxygen demand will experience interference.

B. Suggestions
In studying this material, students and readers should be able to look for various
references so that the content does not deviate from the material and in accordance
with what should be at BPKM.
 REFERENCES

Asmadi, 2008, Nursing Procedural Techniques: Concepts and Applications of Basic

Needs of Clients, Jakarta: Salemba Medika
Hidayat, A. Aziz Alimul. 2006. Introduction to Basic Human Needs: Application of
Nursing Concepts and Processes. Jakarta: Salemba Medika