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PRESENTATION
ON
OXYGEN
INSUFFICIENCY
PERSONAL DATA 1
Name: Mr. Manohar G
Age: 65 year
Sex: Male
Marital status: Married , 3 children
Religion: Hindu
Occupation: Farmer
Educational level: primary level
Language spoken: kannada , tamil, telagu, hindi
Medical diagnosis: Exacerbation of COPD
Date of admission: 12/10/016
Date of discharge: 22/10/016
HEALTH PERCEPTION
Present health history: breathing difficulty, tachypnea, tachycardia,
swelling on the dorsum of the right foot.
Past health history: k/c/o COPD.
Allergies: none
Smoking: 7 per day
Chew tobacco: no
Use of alcohol : no
Family health history
Socio economic data
Health pattern
Rest and sleep
Elimination
INVESTIGATION DONE
Hb: 8.80 g/ dl( anaemia)
Neutrophils: 79.70 % (infection)
Lymphocytes :15.90% (infection)
Serum total protein : 5.20 g/dl
Serum albumin : 1.7 g/ dl
Serum ALT : 14
Serum sodium: 125 mEq/l
Serum potassium :3.37 mEq/l
Serum chloride: 90 mEq/l
MEDICATIONS
Inj. Piptaz 4.5gm iv QSH (beta lactum antibiotics)
Inj. Amikacin 750mg iv OD (systemic aminoglycoside
antibiotics)
Inj. Dexa 4mg iv Q12H (corticosteroids)
Inj. Heparin 5000 U s/c bd (anticoagulant)
Nebulization with Duolin 2oo doses / pack Q8H
Nebulization with Budecort Q12h
Inj. Pan 40 mg OD (proton pump inhibitors)
T. Fluconazole 150 mg OD (antifungal drug)
Oxygen @ 2 l if Spo2 < 94%
PERSONAL DATA 2
NAME MR. VENKATESH
AGE 65 YEARS
SEX MALE
MARITAL STATUS MARRIED
RELIGION HINDU
OCCUPATION SHOPKEEPER
EDUCATIONAL LEVEL INTERMEDIATE (12th STANDARD)
LANGUAGE SPOKEN KANNADA , HINDI
MEDICAL DIAGNOSIS PNEUMONIA
SURGICAL DIAGNOSIS NIL
DATE OF ADMISSION 16/10/16
DATE OF DISCHARGE 22/10/16
DATE AND DURATION 17/10/16-19/10/16
OF CARE GIVEN
PRESENT HEALTH HISTORY-
Mr Venkatesh was admitted to the ward through OPD
with the complaints of fever since 2 days , productive
cough with purulent sputum since 5 days, dyspnoea since 2
days and pleuritic chest pain. After investigation chest X-
ray showed left lower opacity.
PAST HEALTH HISTORY-
He is known case of hypertension since 10 years and
he is taking amlodipine tablet (5mg) OD. He smokes at
least 5 cigarettes per day and he has been drinking alcohol
since 22 years.
INVESTIGATIONS DONE-
MEDICATIONS GIVEN-
INJECTION CEFTRIAXONE 2G BD
TABLET LEVOFLOXACIN 500mg BD
TABLET DOLO 650mg TID
NEB WITH DUOLIN AND BUDEORT TID
O2 SUPPLEMENTATION @ 2L/MINUTE if SPO2 IS <90%
OXYGEN INSUFFICIENCY
INTRODUCTION
THE ONE
WHO
COINED
THE TERM
OXYGEN
HISTORICAL ASPECTS OF
OXYGEN
ANCIENT HINDU CONCEPT OF OXYGEN
The presence of lungs had been recognized in ancient Hindu
medicine. Both Charaka and Susrata the two famous
physicians/ surgeons of the vedic period
(500)BC,RECOGNIZED A ‘PRANA VAYU’, I.E LIFE AIR.
Charaka mentions the head , the chest, the ears, the tongue,
the mouth and the nose as the seat of ‘prana vayu’.Susrata
(1000)BC spoke of ‘ prana vayu’ as flowing in the mouth.
CHARAKA SUSRATA
ANCIENT GREEK CONCEPT
In the 4th century BC, ARISTOTLE identified
few essential elements – earth ,air, fire and
water. The need for air remained well organized
,although its role was not identifiable.
MODERN HISTORY OF OXYGEN
:Paracelsus, a Swiss scientist had suggested in 1541 that
air contained a life sustaining substance.
Priestley called oxygen as the deep dephlogisticated air
Thomas beddoes used oxygen for the first time in early
1800 for treatment of medical disorders.
MODERN HISTORY OF OXYGEN
PARACELSUS PRIESTLY
ANATOMY OF
RESPIRATION
Divisions of the Respiratory System
Upper respiratory
tract (outside thorax)
Nose
Nasal Cavity
Sinuses
Pharynx
Larynx
Divisions of the Respiratory System
Lower respiratory
tract (within thorax)
Trachea
Bronchial Tree
Lungs
Structures of the Upper Respiratory Tract
Pharynx - (throat)
Base of skull to
esophagus
3 divisions
Nasopharynx - behind nose
to soft palate.
Adenoids swell and
block.
Oropharynx - behind
mouth, soft palate to hyoid
bone.
tonsils
Laryngopharynx - hyoid
bone to esophagus.
Larynx: these voice organ that connects the pharynx
and trachea .
the major function of the larynx is the vocalization.
protects the lower respiratory system from foreign
substance and facilitates coughing
It consist of the following
epiglottis,
glottis,
cricoids cartilage
arytenoid cartilage and
vocal cords.
Structures of the Lower Respiratory Tract
Trachea (windpipe)
Larynx to bronchi
Consists of smooth
cartilage and C
shaped rings of
cartilage.
Tracheostomy -
cutting of an opening
in trachea to allow
breathing.
Structures of the Lower Respiratory Tract
Bronchi
Tubes that branch off
trachea and enter into
lungs
Ciliated
Branches: Primary bronchi
—secondary bronchi—
tertiary bronchi—
bronchioles
Bronchioles branch into
microscopic alveolar ducts.
Terminate into alveolar
sacs
Gas exchange with blood
occurs in sacs.
Respiratory Zone
Figure 22.8a
Chapter 22, Respiratory System 26
Structures of the Lower Respiratory Tract
Structures of the Lower Respiratory Tract
Lungs
Extend from
diaphragm to
clavicles
Divided into lobes
by fissures.
Visceral pleura
adheres to the
lungs.
Pleurisy =
inflammation of the
pleural lining
Respiratory Physiology
Pulmonary Ventilation =
breathing
Mechanism
Movement of gases
through a pressure
gradient - high to low.
When atmospheric
pressure (760 mmHg)
is greater than lung
pressure air flows in =
inspiration.
When lung pressure is
greater than
atmospheric pressure
---- air flows out =
expiration.
Breathing
Breathing, or pulmonary ventilation, consists of two
phases
Inspiration – air flows into the lungs
Expiration – gases exit the lungs
Figure 22.13.1
Chapter 22, Respiratory System 32
Expiration
Inspiratory muscles relax and the rib cage descends
due to gravity
Thoracic cavity volume decreases
Elastic lungs recoil passively and intrapulmonary
volume decreases
Intrapulmonary pressure rises above atmospheric
pressure (+1 mm Hg)
Gases flow out of the lungs down the pressure gradient
until intrapulmonary pressure is 0
HEALTH PROMOTION
MOBILIZATION OF THE
OXYGEN
PULMONARY
THERAPY
SECRETIONS
CHEST POSTURAL
NEBULIZATION
PHYSIOTHERAPY DRINAGE
HAZARDS OF OXYGEN INHALATION
O2 ATELECTASIS
INFECTION
TOXICITY
O2
INDUCED
COMBUSTION
APNEA
DAMAGE
DRYING OF
THE MUCUS RETROLENTAL ASPHYXIA
MEMBRANE FIBROPLASIS
METHODS OF OXYGEN DELIVERY
Nasal cannula:
It is the most common inexpensive method used to
administer oxygen to client. It delivers a relatively low
concentration of oxygen (24% to 45%)at flow rate of 2-6
l/min.
But this is not in use nowadays. In these days nasal prongs
are used.
Face mask:
The simple face mask delivers oxygen concentrations from 40% to
60% at flow rate of 5 to 8L/min respectively.
The face mask is sub divided into two types namely
REBREATHER MASK
NON REBREATHER MASK
Rebreather mask
In rebreather mask the oxygen reservoir bag that is
attached allows the client to rebreath the exhaled air in
conjunction with oxygen. Thus it increases
FiO2(fractional oxygen of inspired air) by recycling
expired oxygen.
ADVANCE
OXYGEN
THERAPY
OZONE T
ADVANCE HE RAPY
OXYGEN
THERAPY
NURSING DIAGNOSIS
NURSING DIAGNOSIS 1
Impaired gas exchange related to alveolar hypoventilation
as evidenced by headache on awakening , SaO2 less than
80% at rest .
Ineffective airway clearance related to airway obstruction
, ineffective cough , decreased airway humidity as
evidenced by presence of abnormal breath sounds.
Ineffective breathing pattern related to shortness of
breath evidenced by 30 b/min.
Imbalanced nutrition less than body requirement related
to poor appetite as evidenced by decreased body weight.
CONT…..1
Insomnia related to dyspnea as evidenced by frequent
awakening.
Activity intolerance related to fatigue as evidenced by
dependent on others.
Deficient knowledge related to self care strategies to
be performed at home .
Risk of infection related to corticosteroids therapy.
Assessment Nursing Outcome Implementati Evaluation
diagnosis on