OXYGEN INSUFFICIENCY

INTRODUCTION

OXYGEN IS ESSENTIAL TO LIFE.ALL CELLS IN THE BODY REQUIRES IT,SOME BEING MORE SENSITIVE TO A LACK OF OXYGEN THAN OTHERS.
THE TERM OXYGEN WAS FIRST COINED BY ANTOINE LAVOISIER.
OXYGEN IS A CHEMICAL ELEMENT WITH ATOMIC NO.8
THE NORMAL AMOUNT OF OXYGEN IN THE EXTERNAL BLOOD SHOULD BE IN THE RANGE OF 80-100mmhg.
 MEANING

A COLOURLESS ODOURLESS GAS CONSTITUTING ONE FIFTH OF THE ATMOSPHERE.21% OF OXYGEN PRESENT IN THE ATMOSPHERIC AIR.AIR IS A MIXTURE OF MANY GASES.

DEFINITION OF OXYGENATION

OXYGENATION IS A PROCESS WHICH OCCURS IN THE LUNGS TO THE HAEMOGLOBIN OF BLOOD , WHICH IS SATURATED WITH OXYGEN TO FORM OXYHAEMOGLOBIN.
DEFINITION OF OXYGEN INSUFFICIENCY

OXYGEN INSUFFICIENCY IS DEFINED AS DECREASE IN LEVEL OF

OXYGEN IN THE BODY WHICH RESULTS IN DECREASE IN PERFUSION OF TISSUES AND OTHER BODY CELLS WHICH LEADS TO SERIOUS HEALTH PROBLEMS .

OXYGEN INSUFFICIENCY IS A FAILURE TO PROVIDE ADEQUATE OXYGEN TO CELLS OF THE BODY AND TO REMOVE EXCESS CARBONDIOXIDE FROM CELLS .
ANATOMY OF SYSTEM INVOLVED IN OXYGENATION PROCESS

RESPIRATORY SYSTEM

THE ORGANS OF RESPIRATORY SYSTEM INCLUDE

NOSE
PHARYNX
LARYNX
TRACHEA
BRONCHI
LUNGS
NOSE
PHARYNX
LARYNX
TRACHEA
BRONCHI
LUNGS
 ETIOLOGY

1.CARBON MONOXIDE POISONING

2.CONTACT WITH CERTAIN CHEMICALS
3.SELF INDUCED HYPOCAPNIA
4.SLEEP APNEA
5.DRUG OVERDOSE
6.ACUTE RESPIRATORY DISTRESS SYNDROME
7.HANGING
8.RESPIRATORY DISEASES
9.DROWNING

10.EXPOSURE TO LOW
PRESSURE
FACTORS AFFECTING OXYGENATION

1.MODIFIABLE FACTORS
LIFESTYLE FACTORS
ENVIRONMENTAL FACTORS
2.NON MODIFIABLE FACTORS
DEVELOPMENTAL FACTORS
PHYSIOLOGICAL FACTORS
 LIFE STYLE FACTORS
1.NUTRITIONAL FACTORS

SEVERE OBESITY DECREASES LUNG EXPANSION.

THE INCREASED BODY WEIGHT INCREASES OXYGEN DEMANDS TO MEET METABOLIC NEED.
MALNOURISHED CLIENT MAY EXPERIENCE RESPIRATORY MUSCLE WASTING RESULTING IN A DECREASED MUSCLE STRENGTH AND RESPIRATORY EXCURSION.

2.MEDICATIONS
MANY MEDICATIONS AFFECT THE FUNCTION OF RESPIRATORY SYSTEM.
PATIENTS RECEIVING DRUGS THAT AFFECT THE CNS NEED TO BE MONITORED CAREFULLY FOR RESPIRATORY COMPLICATIONS. EX.OPIOIDS THAT DEPRESS THE
MEDULLARY RESPIRATORY CENTRE.
PHYSIOLOGICAL HEALTH

MANY PHYSIOLOGICAL FACTORS AND CONDITIONS CAN AFFECT RESPIRATORY SYSTEM.

INDIVIDUALS RESPOMDING TO STRESS MAY SIGH EXCESSIVELY OR EXHIBIT HYPERVENTILATION.
GENERALISED ANXIETY HAS BEEN SHOWN TO
CAUSE ENOUGH BRONCHOSPASM TO PRODUCE
AN EPISODE OF BRONCHIAL ASTHMA.

LEVELS OF HEALTH

ACUTE AND CHRONIC ILLNESSES DRMATATICALLY

AFFECT A PERSONS RESPIRATORY FUNCTION.
EX.PEOPLE WITH CARDIAC DISORDERS OFTEN
HAVE COMPROMISED RESPIRATORY FUNCTIONING
BEACUASE OF FLUID OVER LOAD AND IMPAIRED
TISSUE PERFUSION.
CHRONIC ILLNESS OFTEN HAVE MUSCLE WASTING AND POOR MUSCLE TONE.
THESE PROBLEMS AFFECT ALL THE MUSCLES INCLUDING THOSE OF RESPIRATORY SYSTEM.

EXERCISE

EXERCISE INCREASE THE BODY METABOLIC ACTIVITY AND OXYGEN DEMAND RATE AND DEPTH OF RESPIRATOTY INCREASE
ENABLING THE PERSON TO INHALE MORE OXYGEN AND EXHALE EXCESS CO2
PEOPLE WHO EXERCISE FOE ONE HOUR DAILY HAVE A LOWER PULSE RATE,BLOOD PRESSURE,DECREASED CHOLESTEROL LEVEL,INCREASED BLOOD
FLOW AND GREATER OXYGEN EXTRACTION BY WORKING MUSCLES.

SMOKING CESSATION

INHALED NICOTINE CAUSE VASOCONSTRICTION OF PERIPHERAL AND CORONARY BLOOD VESSELS INCREASING B.P AND DECREASING BLOOD FLOW
TO PERIPHERAL VESSELS.
 SUBSTANCE ABUSE
EXCESSIVE USE OF ALCOHOL AND OTHER DRUGS CAN IMPAIR TISSUE OXYGENATION IN TWO WAYS.
THE PERSON WHO CHRONICALLY ABUSES SUBSTANCES OFTEN HAS A POOR NUTRITIONAL INTAKE.
EXCESSIVE USE OF ALCOHOL AND CERTAIN OTHER DRUGS CAN DEPRESS THE RESPIRATORY
CENTER,REDUCING THE RATE AND DEPTH OF RESPIRATION
STRESS REDUCTION

A CONTINUOUS STAGE OF STRESS OR SEVERE ANXIETY INCREASES THE BODYS METABOLIC RATE AND OXYGEN
DEMAND.
THE BODY RESPONCE TO ANXIETY AND OTHER STRESSES WITHIN AN INCREASED RATE AND DEPTH OF
RESPIRATION .
ENVIRONMENTAL FACTORS

ENVIRONMENTAL CAN INFLUENCE OXYGENATION. THE CLIENT’S WORK PLACE MAY INCREASE THE RISK FOR PULMONARY DISEASE. OCCUPATIONAL
POLLUTANTS INCLUDE ASBESTOS, TALCUM POWDER, DUST AND AIRBORNE FIBRES.

ASBESTOSIS IN AN OCCUPATIONAL LUNG DISEASE THAT DEVELOPS AFTER EXPOSURE TO ASBESTOS.

CLIENTS AT RISK FOR DEVELOPING ASBESTOS INCLUDE THOSE WORKING WITH TEXTILES FIRE PROOFING OR MILLING OR IN THE
PRODUCTION OF PAINTS, PLASTICS.

CLIENT EXPOSED TO ASBESTOS WHO ALSO HAVE THE HABITS OF SMOKING MEANS INCREASED RISK OF DEVELOPING LUNG
CANCER.
AIR POLLUTION IS AN IMPORTANT FACTOR THAT EFFECT THE OXYGENATION
SOURCES OF AIR POLLUTION
A) AUTOMOBILES
MOTOR VECHILES ARE A MAJOR SOURCE OF AIR POLLUTION THROUGHOUT THE URBAN AREAS.

B) INDUSTRIES
INDUSTRIES EMIT LARGE AMOUNT OF POLLUTANTS INTO THE ATMOSPHERE.
C) DOMESTIC SOURCES

DOMESTIC COMBUSTION OF COAL, WOOK OR OIL IS A MAJOR SOURCE OF SMOKE, DUST, AND SULPHUR DIOXIDE AND NITROGEN OXIDE.

D) MISCELLANEOUS

BURNING REFUSE, INCINERATORS, PESTICIDE SPRAYING, NUCLEAR ENERGY PROGRAMME AND ALSO NATURAL SOURCES (BACTERIA)
HEALTH ASPECTS

THE HEALTH EFFECTS OF AIR POLLUTION ARE BOTH IMMEDIATE AND DELAYED. IMMEDIATE EFFECTS ARE BORNE BY THE RESPIRATORY SYSTEM, RESULTING STATE IS ACUTE
BRONCHITIS. IF THE AIR – POLLUTION IS INTENSE, IT MAY RESULT EVEN IN IMMEDIATE DEATH BY SUFFOCATION.
2)PHYSIOLOGICAL FACTORS
1. DECREASED OXYGEN – CARRYING CAPACITY

HAEMOGLOBIN CARRIES 99% OF THE OXYGEN TISSUES. ANAEMIA AND INHALATION OF TOXIC SUBSTANCES DECREASES THE OXYGEN – CARRYING
CAPACITY OF BLOOD, BY REDUCING THE AMOUNT OF AVAILABE HAEMOGLOBIN TO TRANSPORT OXYGEN. ANAEMIA LOWER THAN NORMAL
HAEMOGLOBIN LEVEL IS A RESULT OF DECREASED HAEMOGLOBIN PRODUCTION, INCREASED RED BLOOD CELL DESTRUCTION AND BLOOD LOSS.
2. DECREASED INSPIRED OXYGEN CONCENTRATION
WHEN THE CONCENTRATION OF INSPIRED OXYGEN DECLINES, THE OXYGEN CARRYING CAPACITY OF THE CLOOD IS DECREASED. IT MAY LEAD TO RESPIRATORY PROBLEMS.

3. INCREASED METABOLIC RATE INCREASED METABOLIC ACTIVITY CAUSE, INCREASED OXYGEN DEMAND. WHEN BODY SYSTEMS ARE UNABLE TO MEET THIS INCREASED
DEMAND THE LEVEL OF OXYGENATION DECLINES.
DEVELOPMENT FACTORS
INFANTS AND TODDLERS

INFANTS AND TODDLERS ARE AT RISK FOR UPPER RESPIRATORY TRACT INFECTION .
AS A RESULT OF FREQUENT EXPOSURE TO OTHER CHILDREN AND EXPOSURE TO SECONDHAND SMOKER.

SCHOOL AGE CHILDRENS AND ADOLESCENTS

SCHOOL AGE CHILDRENS AND ADOLESCENTS

ARE EXPOSED TO RESPIRATORY INFECTION AND RESPIRATORY RISK FACTORS SUCH AS SECOND HAND SMOKE AND CIGARETTE SMOKING.

YOUNG AND MIDDLE –AGE ADULTS

YOUNG AND MIDDLE AGE ADULTS ARE EXPOSED TO MULTIPLE CARIDOPULMONARY RISK FACTORS SUCH AS UNHEALTHY DIET, LACK OF EXERCISE, STRESS, ILLEGAL DRUGS, SMOKING
AND UNHEALTHY LIFESTYLE.

OTHER ADULTS
VENTILATION AND TRANSFER OF RESPIRATORY GASES DICLINE WITH AGE, BECAUSE THE LUNGS ARE UNABLE TO EXPAND FULLY, LEADING TO LOWER OXYGENATION LEVELS
OTHER ADULTS

VENTILATION AND TRANSFER OF RESPIRATORY GASES DICLINE WITH AGE, BECAUSE THE
LUNGS ARE UNABLE TO EXPAND FULLY, LEADING TO LOWER OXYGENATION LEVELS
SIGNS AND SYMPTOMS

I. RESPIRATORY SYSTEM

1.SHORTNESS OF BREATH
2.CYANOSIS
3. RAPID BREATHING/HYPERVENTILATION
II.CARDIOVASCULAR SYSTEM

TACHYCARDIA
 III.NERVOUS SYSTEM

1.HEADACHE AND CONFUSION

2.DIZZINESS

3.ANXIOUS
IV.GASTRO INTESTINAL SYSTEM

1.NAUSEA AND VOMITING

 V. GENITOURINARY SYSTEM

1.OLIGURIA
2.ANURIA
OTHERS:

FATIGUE
2.LETHARGIC

3.IRRITABILITY
4.CLUBBING OF FINGERS
 DIAGNOSTIC EVALUATION

A. HISTORY COLLECTION

NURSING HISTORY SHOULD FOCUS ON THE CLIENTS ABILITY TO MEET OXYGEN NEEDS.

NURSING HISTORY FOR CARDIAC FUNCTION INCLUDES PAIN, DYSPNEA, FATIGUE, PERIPHERAL CIRCULATION, CARDIAC RISK FACTORS, PRESENCE OF PAST OR CURRENT CONDITION.

COMMON DIAGNOSIS TESTS A. PULMONARY FUNCTION TEST IT HELPS TO DETERMINE THE ABILITY OF THE LUNGS TO EFFICIENTLY EXCHANE AND CARBON DIOXIDE. MEASUREMENT NORMAL RANGE CLINICAL SIGNIFICANCE TIDAL VOLUME (VT) VOLUME OF AIR INHALED OR EXHALED PER BREATH. RESIDUAL VOLUME (RV) VOULME OF AIR LEFT IN LUNGS AFTER A MAXIMAL
EXHALATION. FUNCTIONAL RESIDUAL CAPACITY VOLUME OF AIR LEFT IN LUNGS AFTER A NORMAL EXHALATION. 5-10 ML/KG 1000 – 1200 ML 2000 – 2400 ML DECREASED IN RESTRICTIVE LUNG DISEASE AND OLDER CLIENT. INCREASE IN CLIENTS WITH COPD AND OLDER CLIENTS DUE TO DECREASED RESPIRATORY MUSCLE MASS, STRENGTH, ELASTIC RECOIL AND CHESTWALL
COMPLIANCE. INCREASED IN CLIENTS, WITH COPD AND OLDER CLIENTS DUE TO DECREASED RESPIRATORY MUSCLE MASS, STRENGTH, ELASTIC RECOIL AND CHESTWALL COMPLIANCE. MEASUREMENT NORMAL RANGE CLINICAL SIGNIFICANCE VITAL CAPACITY(VC) VOLUME OF AIR EXHALED AFTER A MAXIMAL INHALATION TOTAL LUNG CAPACITY(TLC) TOTAL VOLUME OF AIR IN
LUNGS FOLLOWING A MAXIMAL INHALATION 4500 – 4800 ML 5000 – 6000 ML DECREASED IN PULMONARY EDEMA A TELECTUSIS AND CHANGES ASSOCIATED WITH A GIVING. DECREASED IN RESTRICTIVE LUNG DISEASE INCREASE IN OBSTRUCTIVE LUNG DISEASE. PEAK EXPIRATORY FLOW RATE (PEFR) THE POINT OF HIGHEST FOLOW DURING MOXIMAL EXPIRATION. NORMAL IS BASED
ON AGE AND BODY WEIGHT. IT IS ROUTINELY USED FOR PATIENTS WITH MODERATE OR SEVERE ASTHMA TO MEASURE THE SEVERITY OF THE DISEASE AND DEGREE OF DISEASE CONTROL. ARTERIAL BLOOD GAS MEASURES THE HYDROGEN CONCENTRATION PARTIAL PRESSURE OF CARBON DIOXIDE, PARTIAL PRESSURE OF OXYGEN, OXYGEN CONCENTRATION. SPIROMETRY
SPIROMETRY MEASURE, THE VOLUME OF AIR IN LITERS EXHALED OR INHALED BY A PATIENT OVER TIME. PULSE OXIMETRY IT IS A NONINVASIVE TECHNIQUE THAT MEASURES THE ARTERIAL OXYHAEMOGLOBIN SATRUATION OF ARTERIAL BLOOD. IT IS USEFUL FOR MONITIORING PATIENTS RECEVING OXYGEN THERAPY, LITRATING OXYGEN THERAPY, MONITORING THOSE AT RISK FOR
HYPOXIA AND POST OPERATIVE PATIENTS. A RANGE OF 95% TO 100% IS CONSIDERED NORMAL SPO2; VALUES LESS THAN 85% INDICATE THAT OXYGENTATION TO THE TISSUE IS INADEQUATE. CHEST X – RAY USUALLY POSTERANTERIOR AND LATERAL FILMS AR ETAKEN TO ADEQUATELY VISUALTIZE ALL OF THE LUNG FIELDS. RADIOGRAPHY OF THE THORUX IS USED TO OBSERVE THE
LUNG FIELD FOR FLUID (PNEUMONIA), MASSE (LUNG CANCER), OTHER ABNORMAL PROCESS. BRONCHOSCOPY VISUAL EXAMINATION OF THE TRACHEOBRONCHIAL TREE THROUGH A NARROW, FLEXIBLE FIBEROPTIC BRONCHOSCOPE. PERFORMED TO OBTAIN FLUID, SPUTUM OR BIOPSY SAMPLES, REMOVE MUCOUS PLUGS OR FOREIGN BODIES. BRONCHOSCOPY VISUAL EXAMINATION
OF THE TRACHEOBRONCHIAL TREE THROUGH A NARROW, FLEXIBLE FIBEROPTIC BRONCHOSCOPE. PERFORMED TO OBTAIN FLUID, SPUTUM OR BIOPSY SAMPLES, REMOVE MUCOUS PLUGS OR FOREIGN BODIES SPUTUM SPECIMENS OBTAINED TO IDENTIFY A SPECIFIC MICRO – ORGANS. ORGANISM GROWING IN THE SPUTUM IDENTIFY DRUG RESISTANCE AND SENSITIVITIES THROUT
CULTURE IT DETERMINES THE PRESENCE OF PATHOGENIC ORGANISMS. POSITIVE RESULTS ARE USED TO DETERMINE THE CORRECT ANTIBIOTIC. FOR TREATMENT BASED ON THE ORGANISM CULTURED.
NURSING HISTORY FOR RESPIRATORY FUNCTION INCLUDES
THE PRESENCE OF A COUGH, SHORTNESS OF BREATH,WHEEZING, PAIN ENVIRONMENTAL
EXPOSURE, FREQUENTLY OF RESPIRATORY TRACT INFECTIONS, PAST RESPIRATORY PROBLEM,
CURRENT MEDICATIONS USE AND SMOKING HISTORY OR SECOND HAND SMOKE EXPOSURE
PHYSICAL EXAMINATION

INSPECTION AT FIRST NURSE HAS TO PERFORM A HEAD TO OBSERVATION OF THE CLIENT FOR
SKIN AND MUCOUS MEMBRANE, GENERAL APPEARANCE LEVEL OF CONSCIOUSNESS, BREATHING
PATTERN AND CHEST WALL MOVEMENT ANY ABNORMALITIES SHOULD BE INVESTIGATED
INSPECTION INCLUDES

OBSERVATION OF THE NAILS FOR CLUBBING. CLUBBED NAILS, OBLITERATION OF THE NORMAL ANGLE
BETWEEN THE USE OF THE NAIL AND THE SKIN, ARE SEEN IN CLIENTS WITH PROLONGED OXYGEN
DEFICIENCY ENDOCARDITIS AND CONGENITAL HEART DEFECTS. INSPECT THE CHEST CONTOUR AND SHAPE.
 PALPATION

PALPATION OF THE CHEST PROVIDES ASSESSMENT DATA IN SEVERAL AREAS. IT DOCUMENTS THE TYPE AND AMOUNT OF
THORACIC EXCURSION, ELICIT ANDY AREAS OF TENDERNESS AND CAN IDENTIFY TACTILE FREMITOSE THE CAPACITY TO
FEEL SOUND ON THE CHEST WALL BY PLACING YOUR PALM TO THE PATIENTS CHEST WALL, AVOIDING BONEY AREAS. ASK
THE PATIENTS TO REPEAT SOME NULTI – SYLLABLE WORD (EG: “NINENTY – NINE”) AND FEEL FOR THE VIBRATION.
 PERCUSSION

PERCUSSION ALLOWS THE NURSE TO DETECT THE PRESENCE OF ABNORMAL FLUID OR AIR IN THE LUNGS. IT ALSO USED TO DETERMINE DIAPHRAGMATIC EXCURSION.

AUSCULTATION

AUSCULTATION ENABLES THE NURSE TO IDENTIFY NORMAL AND ABNORMAL HEART AND LUNG SOUNDS. AUSCULTATION OF THE LUNG SOUND INVOLVES LISTENING FOR
MOVEMENT
OF AIR THROUGHOUT ALL LUNG FIELDS. ANTERIOR, POSTERIOR AND
LATERNAL. ADVENTITIOUS BREATH SOUNDS OCCUR WITH COLLAPSE OF A
LUNG SEGMENT, FLUID IN A LUNG SEGMENT AIR NARROWING OR
OBSTRUCTION OF AN AIRWAY.
1.BRONCHOSCOPY

VISUAL EXAMINATION OF THE TRACHEOBRONCHIAL TREE THROUGH A NARROW, FLEXIBLE FIBEROPTIC BRONCHOSCOPE.
PERFORMED TO OBTAIN FLUID, SPUTUM OR BIOPSY SAMPLES, REMOVE MUCOUS PLUGS OR FOREIGN BODIES
2. PULMONARY FUNCTION TEST

IT HELPS TO DETERMINE THE ABILITY OF THE LUNGS TO EFFICIENTLY EXCHANGE AND CARBON DIOXIDE.THESE ARE USED TO
DETERMINE THE EXTENT OF DYSFUNCTION.

MEASUREMENT NORMAL RANGE CLINICAL SIGNIFICANCE TIDAL VOLUME (VT) VOLUME OF AIR INHALED OR EXHALED PER BREATH.
RESIDUAL VOLUME (RV) VOLUME OF AIR LEFT IN LUNGS AFTER A MAXIMAL EXHALATION
FUNCTIONAL RESIDUAL CAPACITY VOLUME OF AIR LEFT IN LUNGS AFTER A NORMAL EXHALATION.

3.ARTERIAL BLOOD GAS

MEASURES THE HYDROGEN CONCENTRATION PARTIAL PRESSURE OF CARBON DIOXIDE, PARTIAL PRESSURE OF OXYGEN, OXYGEN CONCENTRATION.

SPIROMETRY SPIROMETRY MEASURE, THE VOLUME OF AIR IN LITERS EXHALED OR INHALED BY A PATIENT OVER TIME. PULSE OXIMETRY IT IS A NONINVASIVE TECHNIQUE THAT MEASURES THE ARTERIAL OXYHAEMOGLOBIN SATRUATION OF ARTERIAL BLOOD. IT IS USEFUL FOR MONITIORING
PATIENTS RECEVING OXYGEN THERAPY, LITRATING OXYGEN THERAPY, MONITORING THOSE AT RISK FOR HYPOXIA AND POST OPERATIVE PATIENTS. A RANGE OF 95% TO 100% IS CONSIDERED NORMAL SPO2; VALUES LESS THAN 85% INDICATE THAT OXYGENTATION TO THE TISSUE IS INADEQUATE.
CHEST X – RAY USUALLY POSTERANTERIOR AND LATERAL FILMS AR ETAKEN TO ADEQUATELY VISUALTIZE ALL OF THE LUNG FIELDS. RADIOGRAPHY OF THE THORUX IS USED TO OBSERVE THE LUNG FIELD FOR FLUID (PNEUMONIA), MASSE (LUNG CANCER), OTHER ABNORMAL PROCESS. cccc.
THORACENTESIS THORACENTESIS IS A SURGICAL PROCEDURE OF PUNCTURING THE CHEST AND ASPIRATING PLEURAL FLUID, FOR DIAGNOSTIC OR THERAPEATIC PURPOSES OR TO REMOVE A SPECIMEN FOR BIOPSY. THE PROCEDURE IS PERFORMED USING ASEPTIC TECHNIQUE AND LOCAL
ANESTHESIC. THE CLIENT USUALLY SITS UPRIGHT WITH THE ANTERIOR THORAX SUPPORTED BY PILLOWS OR AN OVER – BED TABLE. SPUTUM SPECIMENS OBTAINED TO IDENTIFY A SPECIFIC MICRO – ORGANS. ORGANISM GROWING IN THE SPUTUM IDENTIFY DRUG RESISTANCE AND SENSITIVITIES
THROUT CULTURE IT DETERMINES THE PRESENCE OF PATHOGENIC ORGANISMS. POSITIVE RESULTS ARE USED TO DETERMINE THE CORRECT ANTIBIOTIC. FOR TREATMENT BASED ON THE ORGANISM CULTURED.
4.SPIROMETRY

SPIROMETRY MEASURE, THE VOLUME OF AIR IN LITRES EXHALED OR INHALED BY A PATIENT OVER TIME.

5.CHEST X – RAY
USUALLY POSTERANTERIOR AND LATERAL FILMS ARE TAKEN TO ADEQUATELY VISUALTIZE ALL OF THE LUNG FIELDS. RADIOGRAPHY OF
THE THORAX IS USED TO OBSERVE THE LUNG FIELD FOR FLUID (PNEUMONIA), MASS (LUNG CANCER), OTHER ABNORMAL PROCESS
6.THORACENTHESIS

7.PULMONARY ANGIOGRAPHY

8.SPUTUM STUDIES

9.THROAT CULTURE
 MANAGEMENT

1.POSITION
2.BREATHING EXERCISES

DEEP BRREATHING EXERCISES

3.ABDOMINAL AND PURSED LIP BRAETHING
4.NEBULISATION
5.OXYGEN ADMINISTRATION

NASAL CANNULA
FACE MASK
NON BREATHER MASK
VENTURE MASK
TRANSTRACHEAL OXYGEN DELIVERY
FACE TENTS
METHODS USED IN CASE OF PEDIATRICS

IN CASE OF INFANTS
IN CASE OF CHILDREN
OXYGEN TENTS
MECHANICAL VENTILATION
PHARMACOLOGICAL TREATMENT

INCLUDES BASDED ON THE CAUSE AND SYMPTOM PHRAMACOLOGICAL TREATMENT PLANNED

BRONCHODILATORS:SALBUTAMOL
STEROIDS IN CASE OF INTERSTITIAL LUNG DISEASES
DIURETICS IN CASE OF PULMONARY EDEMA
 HAZARDS OF OXYGEN INHLATION

INFECTION
COMBUSTION
DRYING OF MUCOUS MEMBRANE
OXYGEN TOXICITY
ATELECTASIS
OXYGEN INDUCED APNEA
RETROLENTAL FIBROPLASIA
DAMAGE
ASPHYXIA
DISEASES WHICH OCCUR DUE TO OXYGEN INSUFFICIENCY
HYPOXIA
HYPOXEMIA
ANOXIA
CYANOSIS
CEREBRAL PALSY
SYNCOPE
CLUBBING OF FINGERS
CHRONIC RESPIRATORY INSUFFICIENCY
ISCHEMIC HEART FAILURE
RENAL FAILURE
 COMPLICATIONS

1.ALTERATIONS IN CARDIAC FUNCTION

2.BAROTRAUMA AND PNEUMOTHORAX

3.PULMONARY INFECTION
NURSING DIAGNOSIS AND INTERVENTIONS

 IMPAIRED GAS EXCHANGE RELATED TO BRONCHO CONSTRUCTION AND INFLAMMATION OF AIRWAYS.

 INEFFECTIVE AIRWAY CLEARANCE RELATED TO INCREASED MUCOUS PRODUCTION DUE TO UPPER RESPIRATORY
INFECTION AND ASTHMA.  ANXIETY RELATED TO DIFFICULTY IN BREATHING AS MANIFESTED BY ASKING MORE DOUBTS.
 INFFECTIVE BREATHING PATTERN RELATED TO NEUROMUSCULAR IMPAIREMENT OF RESPIRATIONS (PAIN, ANXIETY,
DECREASED LEVEL OF CONSCIOUSNESS, RESPIRATORY MUSCLE, FATIGUE AND BRONCHOSPASM.) AS EVIDENCED BY ALTERED
RESPIRATORY RTE.

 FLUID VOLUME DEFICIT RELATED TO SODIUM AND WATER RETENSION AS MANIFESTED BY CRACKLES.
  IMBALANCED NUTRITION LESS THAN BODY REQUIREMENT RELATED TO POOR APPETITE, SHORTNESS OF
BREATH, DECREASED ENERGY LEVEL AND INCREASED CALORIC REQUIREMENT AS EVIDENCED BY WEIGHT LOSS,
WEAKNESS, MUSCLE WAITING. NURSIN G INTERVENTIONS

 IMPAIRED GAS EXCHANGE RELATED TO BRONCHO CONSTRUCTION AND INFLAMMATION OF AIRWAYS

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