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Oxygen Insufficiency
Submitted To Submitted By
Mrs. Monika Solanki Jitendra Bokha
Nursing Lecturer MSc. Nsg. (Pre.)
GCON Jodhpur GCON Jodhpur

Introduction of O2 Insufficiency –
Oxygen insufficiency refers to a condition where there is an
inadequate supply of oxygen to the body's tissues and organs.
This can occur for various reasons, such as respiratory problems
(like lung diseases or breathing difficulties), heart conditions, high
altitude, anaemia, or certain medical emergencies.
When the body doesn't receive enough oxygen, it can lead to
symptoms like shortness of breath, dizziness, confusion, rapid
heart rate, and in severe cases, it can be life-threatening.
Treatment typically involves addressing the underlying cause and, if
necessary, providing supplemental oxygen therapy.

Contd…
All life on earth is based on 5 basic elements: Sulfur, nitrogen,
hydrogen, carbon and oxygen.
Amongst these, the element that is most abundant is oxygen.
Oxygen makes up about 65% of the human body.
Odourless, tasteless, and colourless, oxygen is one of the most
important substances without which life would not be able to
exist.
For example, we can go without food for a number of weeks
and survive, we can even go without water for 3-7 days, but we
cannot survive without oxygen beyond 5 minutes.

Meaning & Physiology of Oxygenation
 Meaning of Oxygenation – “Oxygenation means the delivery of oxygen
to the body tissue and cells.” It is necessary to maintain health.
Physiology of Oxygenation

Oxygenation results from the co-operative
function of 3 major systems:-
Respiratory/Pulmonary system –
Haematological system –
Cardiovascular system –

Lung Volumes and Capacities –
 Tidal Volume – 500 ml
 Inspiratory Reserve Volume –
3000 ml
 Expiratory Reserve Volume –
1000 ml
 Residual Volume – 1500 ml
 Inspiratory Capacity – 3500 ml
 Functional Residual Capacity –
2200 ml
 Vital Capacity - 4500 ml
 Total Lung Capacity – (5700 -
6000 ml)

There are three steps in the process of
oxygenation –
1) Ventilation,
2) Perfusion
3) Diffusion
Pathway of Air – Nasal Cavities (or Oral Cavity) > Pharynx
>Trachea >Primary bronchi (right & left) > Secondary
bronchi > tertiary bronchi > bronchioles > alveoli (site of gas
exchange).

Terminology Related to Ventilation & How
its Possible –
Pulmonary Ventilation – It means movement of air into and out
of lungs. Its main purpose is to supply fresh air.
Ventilation is composed of –
- Inspiration - when air flows into the lungs.
- Expiration - when air moves out of lungs.
Adequate ventilation depends upon –
- Clear airways
- An intact central nervous system and respiratory center
- An intact thoracic cavity capable of expanding and contracting.

Regulation of Respiration –
Neural Regulation – It maintains rhythm and depth of
respiration and balance between inspiration and expiration.
A) Cerebral cortex
B) Medulla oblongata
Chemical Regulation – It maintains appropriate rate and
depth of respirations based on changes in the body's carbon
dioxide, oxygen and hydrogen ion concentration
A) Chemoreceptors

Oxygen Insufficiency By - Jitendra Bokha .pptx

Factors Affecting Oxygenation –
Physiological Factor –
Anaemia
Toxic
inhalant
Airway obstruction
High altitude
Fever
Decreased chest wall motion

Developmental Factor –
o Fetus
o Neonates and infants
o Toddler, preschool-aged children and accidents
o Older adults
Behavioural Factors –
o Lifestyle
o Medication

Environmental Factors – The incidence of pulmonary disease is higher in
smoggy, urban areas than in rural areas. In addition, the client's
workplace may increase the risk for pulmonary disease. Occupational
pollutants include asbestos, talcum powder and silica dust, coal dust.

Sign and symptom of inadequate
oxygenation –
 Anxious and tired
 Headache, dizziness, irritability and memory loss.
 Nausea, vomiting and cyanosis
 Oliguria and anuria
 Fatigue lethargic
 RBC count increases,
 Clubbing of fingers
 Sometime patient may have pain while breathing

Etiological factors –
Decreased haemoglobin & oxygen carrying capacity of blood.
Diminished concentration of inspired oxygen which may occur at
high attitude.
Inability of the tissue to extract oxygen forms the blood in case of
cyanide poisoning.
Decreased diffusion of oxygen from the alveoli to the blood as with
in pneumonia.
Poor tissue perfusion with oxygenated blood as with shock.
Impaired ventilation as with multiple rib fracture or chest traumas.

Disease / abnormalities Which Cause Oxygen
Insufficiency –
Musculoskeletal Abnormalities – Rib cage Deformity, Rib &
sternal fracture or trauma of thoracic region. Some times
kyphosis, lordosis or scolliosis and Pectus excavatum etc.
 Trauma – The person with multiple rib fracture can develop a
flail chest.
Neuromuscular Diseases – Disease such as muscular dystrophy
affects oxygenation of tissue by decreasing the client’s ability to
expand and contract the chest wall. Ventilation is impaired an
atelectasis, hypercapnia and hypoxemia can occur.

CONTD…
 Central Nervous System Alterations – Disease or trauma involving
the medulla oblongata and spinal cord may result in impaired
respiration.
 Myocardial Ischemia
 Angina pectoris
 Myocardial infraction (MI)
 Hypoventilation
 Hypoxia
 Cyanosis
 Cerebral Palsy
 Syncope

Diagnosis & Evaluation of the Patient That Who
Is Having Oxygen Insufficiency –
 History Collection –
 focus on the client’s ability to meet oxygen needs.
 Nursing history for cardiac function includes pain, dyspnoea, fatigue,
peripheral circulation, cardiac risk factors, and presence of past or
current conditions.
 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
Palpation
Percussion
Auscultation

MEASUREMENT NORMAL
RANGE
CLINICAL
SIGNIFICANCE
Tidal volume - (TV)
Volume of air inhaled or
exhaled per breath.
5-10 ml/kg Decreased in restrictive lung
disease and older client.
Residual volume – (RV)
Volume of air left in
lungs after a maximal
exhalation.
1000 – 1200 ml
Increase in clients with COPD and
older clients due to decreased
respiratory muscle mass, strength,
elastic recoil and chest wall
compliance.
Functional residual
capacity – Volume of air
left in lungs after a
normal exhalation.
2000 – 2400 ml
Increased in clients, with COPD and
older
Vital capacity (VC) –
Volume of air exhaled
after a maximal
inhalation
4500 – 4800 ml
Decreased in pulmonary edema an
atelectasis and changes associated
with a giving.
Total lung capacity
(TLC) – Total volume of
air in lungs following a
maximal inhalation
5000 – 6000 ml
Decreased in restrictive lung
disease increase in obstructive lung

Peak Expiratory Flow Rate (PEFR)

MANAGEMENT OF O2 INSUFFICIENCY–
Position – Semi fowler/high fowler/prone position also help to
proper ventilation and diffusion in lungs & to raise
oxygenation .

CONTD…
Breathing
Abdominal and Pursed Lip Breathing
Nebulisation
1. Jet Nebulizer
2. Ultra Sonic Nebulizer
Chest Physiotherapy
Suctioning

CONTD…
Oxygen Therapy
Oxygenation by Applying Nasal Cannula
Oxygenation By Applying An Oxygen Mask
Nasal Catheter
Oxygen Tent
Oxygen Therapy In The Home

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.
Fluid volume deficit related to sodium and water
retention as manifested by crackles.

CONTD…
Infective breathing pattern related to neuromuscular
impairment of respirations (pain, anxiety, decreased
level of consciousness, respiratory muscle, fatigue and
bronchospasm.) as evidenced by altered respiratory
etc.
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.

Nursing Interventions –
1) Impaired gas exchange related to Broncho construction
and inflammation of airways –
Monitor pure oximetry every 4 hrs.
Monitor and evaluate vital sign ever 4 hrs.
Maintain patient in position of comfort.
Evaluate effectiveness of albuterol nebulizer treatments.
Auscultate lung every 4 hrs.

CONTD…
2) Ineffective airway clearance related to increased
mucous production due to upper respiratory infection
and asthma –
Encourage and instruct in coughing and pursed lib
breathing techniques.
Monitor effectiveness of bronchodilators in increasing
expectoration of secretions.
Note characteristics of sputum.
Evaluate respiratory rate and effort.
Encourage increased fluid intake.
Auscultate breath sounds every 4 hrs.

CONTD…
3) Anxiety related to difficulty breathing as manifested by
asking more doubts –
Assess the level of anxiety.
Provide calm reassuring presence.
Utilize therapeutic touch.
Keep patient and family informed of actions taken to improve
breathing.
Use brief, simple explanation.
Maintain quiet, calm environment.
Encourage pursed lip breathing to manage dyspnoea.

Summary
 Toward the summarize today we are discussed introduction of o2 insufficiency,
meaning & physiology of oxygenation, oxygenation results from the co-operative
function of 3 major systems - respiratory/pulmonary system / haematological
system / cardiovascular system / lung volumes and capacities / there are three
steps in the process of oxygenation - ventilation, perfusion, diffusion /
terminology related to ventilation & how its possible / regulation of respiration /
factors affecting oxygenation - physiological factors / developmental factor &
behavioural factors, environmental factors. Sign and symptom of inadequate
oxygenation, etiological factors, disease / abnormalities which cause oxygen
insufficiency/diagnosis & evaluation of the patient that who is having oxygen
insufficiency, management of o2 insufficiency, nursing diagnosis and
interventions.

Conclusion
Oxygen is very essential component for living things so as a nurse
it is fundamental to assess the level of oxygen in body, and if it is
less than necessary action should be taken. Oxygen insufficiency
can lead serious illness like lung diseases or breathing difficulties,
heart conditions, or certain medical emergencies. When the body
doesn't receive enough oxygen, it can lead to symptoms like
shortness of breath, dizziness, confusion, rapid heart rate, and in
severe cases, it can be life-threatening. Treatment typically
involves addressing the underlying cause and, if necessary,
providing supplemental oxygen therapy.

Bibliography
 Chintamani (2011) “Lewis’s medical surgical nursing” published by Elsevier a division of need
Elsevier india private limited page no 1751.
 Suzanne .C. Smeltzer, Brenda Bare (2004) “Brunner & Suddarth’s text book of medical surgical
nursing” published by lippincott williams and wilkins 10th edition. Page no 577, 600,601.
 Potter and Perry (2005) “Fundamentals of nursing” published by most by an imprint of Elsevier,
6th edition. Page no 1068 – 1071. “Fundamentals of nursing the art and science of nursing care”
6th edition volume 2, published by wolters kluwer india private limited New Delhi.
 Dugas (2006) “Introduction to patient care a comprehensive approach to nursing” 4th edition,
volume published by Elsevier New Delhi. Page no 371 – 395
 Kaur, Navndeep. "Advanced Nursing Practice: Concepts, Role, and Evaluation." New Delhi: Jaypee
Brothers Medical Publishers, 2022.

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Oxygen Insufficiency By - Jitendra Bokha .pptx

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