Disease condition

Oxygen Insufficiency during COVID-19.

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Introduction

Oxygen is the most basic need of all living beings and in covid -19 we can see people suffer from oxygen insufficiency.

Oxygen insufficiency means ‘deficient in oxygen’.

The normal range of oxygen in the external blood should be 80-100mmHg.

For treating oxygen insufficiency effectively, early diagnosis and correct cause should be ruled out.

The only management for oxygen insuffiency is oxygen administration.

Definition

  • Is a condition in which the body as a whole is deprived of adequate oxygen supply.
  • A failure to adequately provide oxygen to the cells of the body and to remove excess carbon dioxide from them.

Anatomy involved in oxygenation process

The respiratory system (also referred to as the ventilator system) is a complex biological system comprised of several organs that facilitate the inhalation and exhalation of oxygen and carbon dioxide in living organisms (or, in other words, breathing).For all air-breathing vertebrates, respiration is handled by the lungs, but these are far from the only components of the respiratory system. In fact, the system is composed of the following biological structures: nose and nasal cavity, mouth, pharynx, larynx, trachea, bronchi and bronchioles, lungs and the muscles of respiration.

A properly functioning respiratory system is a vital part of our good health. Respiratory infections can be acute and sometimes life threatening. They can also be chronic, in which case they place tremendous long term stress on the immune system, endocrine system, and much more.                                                                              

                                Description: Respiratory System

  • Etiology of oxygen insufficiency:-
  • Developmental factors
  • Physiological factors
  • Behavioral factors
  • Lifestyle factors
  • Environmental factors
  • Medication
  • Signs and symptoms
  • Anxiety and tiredness
  • Shortness of breath
  • Headache and Dizziness
  • Irritability

Memory loss

  • Nausea, vomiting
  • Oliguria/anuria
  • Visual impairment
  • Clubbing of fingers

Impairment in judgement 

  • Diagnostic Evaluation
  • History – respiratory diseases, cough, pain, sputum.
  • Physical examination
  • PFT – to find the volume of air in the lungs.
  • ABG – measuring arterial oxygen and carbon dioxide tensions.
  • Sputum studies
  • Chest X-rays and CT scan – to assess fluid, tumors, foreign bodies, and pathological conditions.
  • Bronchoscopy- To remove foreign bodies from the tracheobronchial tree
  • Thoracentesis – to diagnose and treat pleural effusion

Pulmonary angiography

Management

  • Provide proper Position
  • Provide Breathing exercise
  • Administer Nebulization
  • Give Chest physiotherapy
  • Do Suction
  • Oxygen therapy

List of Nursing Diagnosis

  • Ineffective airway clearance related to obstruction of bronchi secondary to infection and inflammation as evidenced by cough and shortness of breath.
  • Ineffective breathing pattern related to copious secretions secondary to restrictive pulmonary disease as evidenced by altered findings in pulse oximetry.
  • Impaired gas exchange related to ventilation-perfusion mismatch secondary to emphysema as evidenced by altered findings in ABG.
  • Decreased cardiac output related to edema in the lungs secondary to congestive heart failure as evidenced by crackles and pink frothy sputum.
  • Oxygen Administration
  • Nasal cannula: is the most inexpensive method, delivers low concentration of oxygen(25% to 45%) at a flow, the rate of 2-6 l/min.
  • Face Mask :it delivers oxygen concentration from 40-60% at a flow rate of 5-8l/min
  • Non breather mask: delivers higher concentration of oxygen 95-100%
  • Venturi mask: delivers 24-50% concentration at a flow rate of 4-5l/min, it also has wide bore tubing and colour coded jet adaptors that correspond to a precise oxygen concentration and flow rate.
  • Trans tracheal oxygen:-  used for oxygen dependent patients. Oxygen is delivered through a small narrow plastic cannula surgically inserted through the skin
  • Face  tents :- used in patients who cannot tolerate masks. They provide 30-50% of oxygen concentration at a flow rate of 4-8l/min
  • Oxygen hood:- it is rigid plastic dome that encloses on infant’s head. It provides precise oxygen levels and high humidity.

Nurses’ responsibility for administration of oxygen:

  • Check the name, bed number and other identification data of the patient.
  • Confirm diagnosis and the need of oxygen therapy.
  • Assess the patient for any sign of anoxia e.g.cyanosis and assess the breathing pattern.
  • Monitor for the results of ABG.
  • As oxygen is a drug, monitor for toxicity.
  • Check that the oxygen is properly humidified.
  • Take precautions to prevent the entry of micro organisms and infection to the patient.
  • Discontinue the oxygen therapy gradually. Gradually wean the patient by reducing the dosage and administering it intermittently.
  • Pay attention to kinks in tubing, loose connections and faulty humidifying apparatus as it may interfere with flow of oxygen.
  • Since oxygen supports combustion, fire precautions are to be taken when oxygen is on flow. Give proper instructions to the relatives of the client regarding this.

Hazards of oxygen inhalation:

  • Atelectasis
  • Oxygen induced apnoea
  • Retrolental fibroplasias
  • Asphyxia
  • Infection
  • Combustion
  • Drying of the mucus membrane of the respiratory tract.
  • Oxygen toxicity

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