NCMA 113 – TOPIC

COVERAGE:  Oxygen, a clear, odorless gas that constitutes

 IV Fluid Computation approximately 21% of the air we breathe
 Oxygenation combustion
 Eliminations  Necessary for proper functioning of all the living
o Micturation/Urine Elimination cells.
o Bowel Elimination  The absence of oxygen can lead to cellular, tissue,
 Catheterization and organism death.
 Suctioning  Although the delivery of oxygen to body tissue is
o Oro and Naso affected at least
 Enema indirectly by other body systems, the respiratory
 Blood transfusion system is most directly involved in this process.
 Death and dying  Impaired function of the system can significantly
 IV Flow computation affect our ability to breathe, transport gases, and
 IV Therapy participate in everyday activities.

IV FLUID COMPUTATION Oxygen Therapy PURPOSE

 To relieve hypoxia and provide adequate tissue
OXYGENATION oxygenation
RESPIRATORY SYSTEMS STRUCTURE
 UPPER AIRWAY Oxygenation Delivery System: Oxygen Administration
o Nasopharynx  Independent Action
o Oropharynx o As an Emergency Measures
o Larynx o The nurse may give O2 (at least 2 L/min) then
 LOWER AIRWAY contact AP (Attending Physician) for an order.
o Trachea o Considered to be a process similar to
o Bronchioles medication administration requiring similar
o Alveoli nursing actions.
o Determining effectiveness involves:
Functions of Respiratory System o Checking VS
 The exchange of oxygen and carbon dioxide o Peripheral Blood Oxygen Saturation (pulse
through respiration oximetry)
 Also plays a role in maintaining acid base balance  Dependent Action
 Begins at the nose continues as a series of airways o Prescribed by physician, who specifies the
or passages extending to the alveoli where gas concentration, method of delivery, liter flow per
exchange takes place minute (L/min) – Lpm depends on the method.
 The primary muscle of respiration is the
diaphragm Precaution for Oxygen Used
 The secondary muscles are called the accessory A. Client with COPD flow rate at 1 to 3 L/min
muscles (Anterior & Posterior) B. Retrolental fibroplasia and blindness in infants
C. Oxygen delivered without humidification will
Factors Affecting the Respiratory System result in drying and irritation or respiratory
HMEALS mucosa
 Health status D. Oxygen supports combustion
 Medicine
 Environmental factors Oxygen Delivery Systems
METHOD O2 CONCENTRATION FLOW RATE / MIN.
 Age
Nasal Cannula 24-45% 2-6 L/min
 Lifestyle Simple Face Mask 35-65% 8-12 L/min
 Stress Partial Rebreather 40-60% 6-10 L/min
Mask
Oxygen Non-Rebreather 60-100% 6-15 L/min
Mask
Venturi Mask Blue 24% 4 L/min

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 NCMA 113 – TOPIC

Adapter  Rubber Catheter 2-3 weeks

Venturi Mask Green 35% 9 L/min  Silicone Catheter 2-3 months
Adapter
Face tent 28-100% 8-12 L/min
 PVC Catheter 4-6 weeks comfortable

Most the Highest concentration of O2 – NON- Size of Catheters

REBREATHER Male Fr. 16 - 18
Female Fr. 12 - 14
Same passage of respiratory and digestive tract – Child Fr. 8 – 10
PHARYNX Infant Fr. 5 - 8

PRECATION Catheter Lengths

 Away at the outlet  Paediatric – 30 cm
 No smoking signage  Female – 26 cm
 No wool materials  Male – 43 cm
 Oil greasy
To empty the urine the catheter need to used –
MICTURATION/URINARY ELIMINATION ORANGE
CHARACTERISTIC OF NORMAL URINE
Amount 24hr 1200ml – 1500ml 30cc/hr Common catheter use – COUDE TIP
Color Strew, Amber transparent
Odor Faint aromatic How many days to stay catheter – 2 DAYS
Sterility No m.o.
pH 4.5 - 8 DETRUSOR MUSCLE – good muscle tone
Specific Gravity 1.010 PELVIC MUSCLE TONE – retain urine voluntary
Glucose, Blood, Ketone Absent Renal Failure – stops urine production
Heart Failure, Shock, and Hypertension - affect blood
Catheterization PURPOSES flow
 To relieve discomfort due to bladder distention or Calculus / Urine Stone - blocks urine
provide gradual decompression of a distended Hypertrophy of prostate gland - obstructs urethra,
bladder impairs urine flow & emptying
 To assess the amount of residual urine if the
bladder empties incompletely Medication
 To obtain urine specimen Diuretics - increase
 To empty the bladder completely prior to surgery Anticholinergics - decrease
 To facilitate accurate measurement of urinary
output for critically ill clients whose output needs  Polyuria
to be monitored hourly o Polyuria (or diuresis) refers to the production
 To provide for intermittent or continuous bladder of abnormally large amounts of urine by the
drainage and irrigation kidneys.
 To prevent urine from contacting an incision after  Oliguria
perineal surgery o Oliguria is low urine output, usually 500 ml a
 To manage incontinence when other measures day
have failed  Anuria
o Anuria refers to a lack of urine production.
Types of Catheter  Urinary frequency
1. Indwelling catheter o Voiding at frequent intervals more than the
o Tube will make balloon
usual
2. Non-Indwelling catheter
 Nocturia
o One time use o Voiding more than two times at night
 Urinary urgency
Types of Catheters o Feeling that a person must void immediately
 Plastic Catheter 1 week or less

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 NCMA 113 – TOPIC

 Dysuria Diarrhea
o Voiding that is either painful or difficult Passage of liquefied stool with increased
 Enuresis frequency and consistency
o Involuntary urination
Bowel (Fecal) Incontinence
 Urinary retention
o Results from over distention of the bladder Primary causes
o Incomplete emptying of the bladder
 Dysfunction anal sphincter
 Disorders to the delivery of the stool to the
 Neurogenic bladder
rectum
o Unperceived bladder fullness
 Disorders of rectal storage
 Anatomic defect
 Loss of ability to control fecal and gaseous
Urinary Retention – distended
discharges
Forms of Incontinence
Stress Incontinence
Enema PURPOSES
Urge Incontinence
 Relieve constipation
Functional Incontinence
 Treat fecal impaction
Extra-Urethral Incontinence
 Deliver medications
 Prepare for medical procedures
BOWEL ELIMINATION
 Bowel emptying
Melena – black tarry
 Administration of medicines
Hematochezia – bright red blood
Steatorrhea – greasy, bulk
Types of Enema
Acholic Stools – gray, pale or clay colored
 Cleansing enema
 Return-Flow enema
Factors affecting Bowel Elimination
 Oil retention enema
 Age  Cooling enema
o Newborn – meconium
o Infants – frequent Low enema - descending colon, le\ sim’s, 12 inches
o Toddlers (1 ½ to 2) – toilet training High enema- descending colon-transverse colon-
o Adolescent – habits like adult ascending colon
o Elders - constipation -le\ Sim’s - supine-right Sim’s- 12-18 inches
 Diet
o Fiber
o Low residue diet
 Fluid
 Activity
 Psychological factors
 Defection habits
 Medication
 Diagnostic procedure

Common Alternation in Bowel

Elimination
Constipation
The infrequent & difficult passage of
hardened stool
Fecal Impaction
Bolus of hardened stool

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