1. OXYGENATION
OBJECTIVES
Define oxygenation
Describe oxygen transportation and uptake
List factors affecting oxygenation
Outline signs and symptoms of hypoxia
Explain oxygen administration

2. definition
• Oxygenation is the delivery of oxygen to the body
tissues and cells.
Physiology of oxygenation
The delivery of oxygen to body cells is a process
that depends on the interplay of the pulmonary,
hematologic and cardiovascular systems.
Specifically, the process involved include:
ventilation, alveolar gas exchange, oxygen
transport and delivery and cellular respiration

3. Oxygen transport and delivery
• Once the diffusion of oxygen across the
alveolar- capillary membranes occurs, the
oxygen molecules are dissolved in blood
plasma. Three factors influence the capacity of
blood to carry oxygen and these are:
• The amount of oxygen dissolved in plasma
• The amount of hemoglobin
• The tendency of hemoglobin to with oxygen

4. • The oxygen carrying capacity of blood is greatly
affected by the presence of hemoglobin in the
erythrocytes.
• The amount of oxygen carried in a sample of
blood is measured in two ways:
• Oxygen dissolved in plasma (partial pressure)
• Normal partial pressure(PaO2) is 80 to 100mmhg.
• The vast majority of oxygen is in the blood bound
to hemoglobin molecules

5. • The amount of oxygen bound in hemoglobin is
expressed as percentage of hemoglobin that is
saturated with oxygen(SaO2) with 100% being
fully saturated.
• Normal saturation of arterial blood is about 96
to 98%

6. FACTORS AFFECTING OXYGENATION
• Adequate oxygenation is influenced by many
factors including: age, environmental and life
style factors and disease process
• Age: older adults may exhibit a barrel chest
and require increased effort to expand the
lungs. Older adults are also more susceptible
to respiratory infections because of decreased
activity of cilia which normally are effective
defense mechanism .

7. Environmental and lifestyle factors
• environmental and lifestyle factors can
significantly affect clients oxygenation status.
• Clients who are exposed to dust, animal dander,
chemicals in the home or workplace are at
increased risk for alteration in oxygen
• Individuals who experience significant physical or
emotional stress or who are obese or
underweight are also subject to changes in
oxygenation status.
• Smokers and second hand smokers are also
affected

8. Disease process
• Oxygenation alterations can often be traced to
alteration in alveolar gas exchange, oxygen
uptake or circulation.
• Diseases that may affect oxygenation include:
obstructive pulmonary disease,
atherosclerosis heart failure, anaemia

9. Clip showing normal, partially and
occluded blood vessel

10. Physiological response to reduced
oxygenation
• When oxygen delivery is inadequate to meet
metabolic needs of the body, various
responses to this deficit can be expected and
these include: increased oxygen extraction,
anaerobic metabolism, tissue ischemia and
cell death.
• Signs and symptoms of hypoxia:
• Early signs: restlessness , dizziness, increased
pulse rate

11. • If hypoxia remains untreated, the respiratory rate
may decline and changes in the level of
consciousness may progress to stupor or comma
• Perfusion deficits resulting in poor circulation can
obviously be noted in the skin cyanosis( bluish
discoloration of the skin) which can also easily be
seen in the tongue, soft palate and conjunctiva of
the eye( these indicate hypoxemia)
• Cyanosis of extremities, nail beds and earlobes is
often as a result of vasoconstriction and stagnant
blood flow.

12. Clubbing of the fingers which
manifests as a flattened angle of the
nail bed and rounding of fingertips is a
sign of chronic hypoxia

13. Interventions to improve oxygen
uptake and delivery
• Oxygen administration
• Oxygen uptake in the pulmonary capillary
beds can be improved by increasing the
concentration of oxygen in the alveolar air and
this increases partial pressure of oxygen in the
alveoli( PaO2) increase the driving pressure for
gas diffusion across capillary membranes.

14. Complications of oxygen
administration
• Oxygen administration, like administration of
any drug is not without hazard. Clients who
have chronic pulmonary disease associated
with carbon dioxide retention may become
sensitive to carbon dioxide levels to their
respiratory rate . These may depend upon
chronic low oxygen level in the blood to drive
their respiratory drive

15. • Oxygen toxicity
• Prolonged administration of high oxygen levels
(greater than 50%) for more than 24 hours may
damage the tissue and produce severe
respiratory difficulties.
• Oxygen can be administered as dry or humidified
• Dry oxygen irritates respiratory mucosa
• Humidified oxygen is preferred
• Administration of high pressured oxygen leads to
low oxygen uptake

16. ADMINISTRATION OF OXYGEN
• Definition: it is a procedure that involves giving of
oxygen to a patient
• Its objective is to supplement oxygen to the vital
organs for normal functioning where oxygen is
insufficient
• Requirements: oxygen concentrator, a bag with
the following: nebulizer/bottle of distilled water
or normal saline, glass rod and tube fixed on the
bottle
• Oxygen mask/ nasal canula, tubing catheter,
strapping for fixing the catheter

17. procedure
• Explain the procedure to the patient and
guardians to gain the patients cooperation
and allay anxiety
• Position the patient comfortably to promote
ease breathing difficulties
• Wipe and clear the nostrils to ensure that the
airway is clear.

18. Equipment preparation/environment
• Remove all articles that can cause fire around
the oxygen giving area.
• Create enough space to accommodate
equipment
• Bring the equipment to the patients bed side
• Connect the equipment
• Put catheters, strapping and scissors on a tray

19. method
• Wash hands to prevent cross infections
• Connect nasal canula
• Turn on the oxygen source at prescribed rate(2-6 litres
/minute in adults and 2litres/minute in children) to
ensure that the patient is getting the required amount
• Check that oxygen is flowing through the tube by
dipping in galipot of water to see if it is bubbling
• If using nasal catheter , measure and mark the length
of the catheter to be inserted to make sure it is not too
long or too short to ensure adequate delivery of
oxygen. Insert catheter about 2cm.

20. Method continued…….
• Strap in the cheek to secure it
• If using nasal prongs lubricate the prongs to
prevent trauma
• Place the prongs in the nostrils to ensure
adequate supply of oxygen
• Adjust according to size to secure the prongs
in position
• If using a mask, fit in position by fastening the
tapes to ensure optimal supply of oxygen

21. Method ct….
• Make sure the mask covers the mouth and
nostrils to ensure full supply of oxygen
• Observe the patient closely for color,
breathing pattern, to monitor response to
therapy. Encourage to breathe normally help
him to relax.
• Wipe and dry patients face to leave patient
comfortable.

22. After procedure
• If mask and canula are reusable:
• Decontaminate in appropriate solution
• Clean well with soap and water and dry
• Send for sterilization
• Keep the oxygen set in appropriate place
• If mask and canulas are disposble, discard
• Document the procedure and observations
made.