Nursing Intervention to Promote

Oxygenation
 Assessment

 Maintenance of patent airway

 Oxygen administration

 Suctioning

 Chest physiotherapy

 Care of chest drainage

 Measurement of oxygen saturation using pulse oximeter

 1. Assessment

 Look (Inspection) at the way the chest rises & falls how fast, is
it equal, how deep.

 Listen (Auscultation) to the sound of the lungs can you hear

an audible sound, is air entry equal, are there any usual sound.

 Feel (Palpation) place your hand on the chest, feel the depth of
breathing, the symmetry.
 Check for >

1.Airways- is this patent ? Observe for signs of airways

obstruction.

2.Breathing- Assess the rate, the type & pattern of

breathing.

3.Circulation- Check B.P. & observe for sign of

hypovolemia.

4.Disability- Assess activity tolerance.

Taking a background history >

 Family history

 Occupation

 Sick contacts

 Smoking

 Medication
Ask your patient about current symptoms>
 Chest pain
 Fatigue
 Cough
 Allergies
 Medications
 Dyspnoea & change in exercise tolerance
 Wheezing
 Night sweats, weight loss
 2.Maintenance of patent airway

 Proper positioning

 Insert an oral or nasal airway

 Assess for any foreign bodies

 Observe whether the tongue is fallen back

 Clear any blockages in the mouth by suctioning

 3.Oxygen administration
Oxygen therapy

Purpose :-

• To facilitate normal metabolism of tissues.

• To reduce or correct arterial hypoxemia & tissue hypoxia.
Indications for oxygen therapy>
• Cyanosis
• Low Spo2 in blood
• Increase in pulse rate, decreased BP & rapid, shallow breathing
• Increased BP
• Cardiac pain, muscle twitching
• Pulmonary diseases
• Cardio vascular disorders
• Blood disorders
• Confusion, headach
Methods of oxygen delivery>
• Nasal catheter

• Nasal cannula

• Face mask

• Venturi mask
 5. Chest Physiotherapy :-
• Chest Physiotherapy (CPT) is an airway clearance technique that
typically involves the assistance of another individual (e.g., caregiver,
trained family member, or respiratory therapist) to manually perform
chest percussion on a patient's chest wall.
3 Techniques of CPT -
1. Percussion
2. Vibration
3. Postural drainage
4. Coughing
Chest Physiotherapy(CPT)>
• Indications:
Bronchiectasis
Atelectasis
Lung abscess
Neuromuscular diseases
Pneumonia
Cystic fibrosis
• Contraindications :-
Increased ICP
Unstable head or neck injury
Active hemorrhage with hemoptysis
Recent spinal injury
Empyema
Bronchopleural fistula
Rib fracture
Fail chest
Uncontrolled hypertension
Anticoagulation
1. Percussion :-
• Chest percussion is clapping of the chest with percussor cups, which
are similar to suction cups. This vibrates the airways in the lungs. The
vibration helps loosen mucus so it can be coughed out.

Percussion can be performed in two ways-

1.Manual Percussion

2.Mechanical Percussion
2. Vibration :-
Vibration is a technique that gently shakes the mucus so it
can move into the larger airways. The caregiver places a firm
hand on the chest wall over the part of the lung being drained
and tenses the muscles of the arm and shoulder to create a fine
shaking motion.
 3. Postural Drainage :-
Postural drainage is a technique that involves laying/ sitting in certain
positions to drain secretions from your airways using gravity. Depending on
the areas of your lungs most affected by secretions, there will be certain
positions that will work best in maximising the benefit of your airway
clearance.

Postural Drainage Positions :

1. Posterior basal segment.
2. Lateral basal segment.
3. Anterior basal segment.
4. Superior segment.
 6. Chest Drainage :-
Chest drainage is a procedure to drain fluid from the pleural space between
the lung and chest wall. Inflammation, infection and traumatic injury, among
other things, can cause fluid to build up in the cavity.

Risks
The procedure is considered low-risk. However, potential complications include:
 bleeding
 infection
 collapse of the lung (pneumothorax)
 bleeding into the chest (hemothorax)
 injury to surrounding structures such as veins or arteries
Types of chest drainage system :-
Once a chest tube is in place, a chest drainage system (CDS) is
attached.
There are basically four types of CDS: 
1. one-way Heimlich valve,
2. analog three-container systems,
3. digital or electronic CDS,
4. simple vacuum bottles (for IPC drainage)
Indications of chest drainage :-

1. Pneumothorax -
A pneumothorax is an abnormal collection of air in the pleural space between the lung
and the chest wall.

2.Hemothorax-
Hemothorax is a collection of blood in the space between the visceral and parietal pleura
(pleural space).

3.Pleural Effusion-
Pleural effusion is an abnormal, excessive collection of this fluid.
Purpose of chest drainage :-
1. a collapsed lung
2. a lung infection like bacterial pneumonia complicated by collection of pus
3. pneumothorax, which is air around or outside the lung
4. bleeding around your lung, especially after a trauma (like a car accident)
5. fluid buildup due to another medical condition, like cancer or pneumonia
6. breathing difficulty due to a buildup of fluid or air
7. surgery, especially lung, heart, or esophageal surgery
Incentive Spirometry :-
• An incentive spirometer is a medical
device that helps your lungs recover
after surgery or a lung illness. You may
find it challenging to use the device at
first, but keep it up! The more you use an
incentive spirometer, the stronger your
lungs will get.