Basic Nursing Skills and Procedures | Oxygenation and Respiratory Care |

 

Basic Nursing Skills and Procedures :

Oxygenation and Respiratory Care :

1. Anatomy and Physiology of the Respiratory System

The respiratory system is responsible for gas exchange, allowing oxygen to enter the bloodstream and carbon dioxide to exit. Understanding the anatomy and physiology of this system is crucial for providing effective respiratory care.

1.1 Components of the Respiratory System

  1. Upper Respiratory Tract:

o    Nose: Warms, humidifies, and filters air.

o    Nasal Cavity: Contains mucous membranes and cilia to trap particles.

o    Pharynx (Throat): Passage for both food and air.

o    Larynx (Voice Box): Prevents food from entering the airway and produces sound.

  1. Lower Respiratory Tract:

o    Trachea (Windpipe): Connects larynx to the bronchi, lined with cilia to trap debris.

o    Bronchi and Bronchioles: Branching airways leading to the lungs.

o    Alveoli: Tiny air sacs where gas exchange occurs.

  1. Lungs:

o    Paired organs located in the thoracic cavity.

o    Contain millions of alveoli to facilitate oxygen-carbon dioxide exchange.

  1. Muscles of Respiration:

o    Diaphragm: Main muscle of respiration, contracts during inspiration.

o    Intercostal Muscles: Help expand and contract the thoracic cavity.

1.2 Physiology of Breathing

  • Inhalation (Inspiration): Diaphragm contracts, thoracic cavity expands, air is drawn into the lungs.
  • Exhalation (Expiration): Diaphragm relaxes, thoracic cavity reduces in size, and air is expelled from the lungs.
  • Gas Exchange: Occurs at the alveoli, oxygen diffuses into the blood while carbon dioxide diffuses out.

2. Oxygen Therapy, Inhalation Therapy, and Use of Nebulizers

Oxygen therapy is the administration of oxygen to patients who are unable to maintain adequate oxygen levels. It is a critical component of respiratory care in nursing.

2.1 Indications for Oxygen Therapy

  • Hypoxemia (low oxygen levels in blood)
  • Respiratory distress
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Post-surgical recovery

2.2 Methods of Oxygen Delivery

  1. Nasal Cannula: Delivers oxygen at low flow (1-6 L/min) and is comfortable for patients.
  2. Simple Face Mask: Delivers oxygen at 5-10 L/min.
  3. Non-Rebreather Mask: Delivers high concentrations of oxygen (up to 100%).
  4. Venturi Mask: Provides precise oxygen concentration and is used for patients with COPD.
  5. High-Flow Nasal Cannula (HFNC): Delivers heated, humidified oxygen at higher flow rates.

2.3 Inhalation Therapy
  • Definition: Inhalation therapy involves the delivery of medications or humidified air to the respiratory system to manage respiratory conditions.
  • Commonly Used Devices:

o    Metered-Dose Inhalers (MDIs): Deliver measured doses of medication.

o    Dry Powder Inhalers (DPIs): Use the patient’s breath to inhale powdered medication.

o    Nebulizers: Convert liquid medication into a fine mist for inhalation.

2.4 Use of Nebulizers

  • Definition: A device that converts liquid medication into a fine mist, which is inhaled into the lungs.
  • Indications: Used for asthma, COPD, and other respiratory conditions.
  • Steps for Use:

1.       Wash hands and gather equipment (nebulizer, compressor, tubing, medication).

2.       Add the prescribed medication to the nebulizer cup.

3.       Attach the tubing and mouthpiece or mask.

4.       Turn on the machine and ensure mist formation.

5.       Instruct the patient to breathe in slowly and deeply through the mouth.

6.       Continue treatment until medication is used up (5-10 minutes).

3. Suctioning Techniques (Oral, Nasopharyngeal, Tracheal)

Suctioning is the process of removing secretions from the airway to maintain a clear airway and promote effective breathing.

3.1 Indications for Suctioning

  • Ineffective cough
  • Excessive secretions
  • Obstructed airway
  • Post-surgical care

3.2 Types of Suctioning

  1. Oral Suctioning:

o    Definition: Removal of secretions from the mouth using a suction catheter or Yankauer suction.

o    Procedure:

1.       Wash hands and wear gloves.

2.       Position the patient in a semi-Fowler’s position.

3.       Insert the suction catheter into the mouth and apply suction while withdrawing the catheter.

4.       Encourage the patient to cough during the process.

  1. Nasopharyngeal Suctioning:

o    Definition: Removal of secretions from the upper airway (nasopharynx) using a sterile suction catheter.

o    Procedure:

1.       Wash hands, wear gloves, and ensure patient privacy.

2.       Position the patient in a semi-Fowler’s position.

3.       Lubricate the catheter tip and gently insert it into one nostril.

4.       Apply suction intermittently for 10-15 seconds while rotating the catheter.

5.       Remove the catheter and allow the patient to breathe normally before repeating.

  1. Tracheal Suctioning:

o    Definition: Removal of secretions from the trachea through a tracheostomy or endotracheal tube.

o    Procedure:

1.       Wash hands, wear sterile gloves, and maintain a sterile field.

2.       Connect the suction catheter to the suction machine.

3.       Insert the catheter into the tracheostomy or endotracheal tube without suction.

4.       Apply intermittent suction for 10-15 seconds while rotating the catheter.

5.       Remove the catheter and oxygenate the patient between attempts.

3.3 Precautions During Suctioning

  • Use sterile equipment to prevent infection.
  • Do not apply continuous suction to avoid tissue damage.
  • Monitor oxygen saturation and respiratory status during the procedure.
  • Avoid over-suctioning, which can lead to hypoxia or airway trauma.



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