Chapter 40 Oxygenation Flashcards
supply the oxygen demands of the body:
The cardiac and respiratory systems
The exchange of respiratory gases occurs between
the environment and the blood
Respiration is the exchange of
oxygen and carbon dioxide during cellular metabolism.
Neural and chemical regulators control the
rate and depth of respiration in response to changing tissue oxygen demands.
Ventilation:
the process of moving gases into and out of the lungs
Perfusion:
The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs
(color of skin - pink is good)
Diffusion:
Exchange of respiratory gases in the alveoli and capillaries
Inspiration:
active process
Expiration:
passive process that depends on elastic recoil properties
Surfactant:
chemical produced in the lungs to maintain surface tension
Atelectasis:
collapse of the alveoi that prevents normal exchange of oxygen and carbon dioxide
Stroke volume:
the volume of blood ejected from ventricles during systole
Deoxygenated blood
- Blood high in carbon dioxide and low in oxygen
2. To right side of heart, then to lungs
Oxygenated blood
- Blood high in oxygen and low in carbon dioxide
2. From the lungs to left side of heart out to rest of body
Myocardial:
Pumping action essential to oxygen delivery
-heart muscle
Factors affecting oxygenation: Physiological
- Decreased oxygen-carrying capacity
- Hypovolemia
- Decreased inspired oxygen concentration
- Increased metabolic rate (fever)
-Decreased oxygen-carrying capacity
Anemia and CO posioning
Hypovolemia
low blood volume
-related to severe dehydration and shock
Chest wall movement
- Pregnancy
- Obesity
- Musculoskeletal abnormalities
- Trauma
- Neuromuscular abnormalities (polio)
- Central nervous system alterations (paralysis)
Chronic diseases:
chronic obstructive pulmonary disease
preload:
end-diastolic volume
afterload:
resistance of left ventricle ejection
NSR:
Normal sinus rhythum - normal sequence on ECG
Hyperventilation:
Ventilation in excess of that required to eliminate carbon dioxide produced by cellular metabolism
Hypoxia:
Inadequate tissue oxygenation at the cellular level
Hypoventilation:
Alveolar ventilation inadequate to meet the body’s oxygen demand or to eliminate sufficient carbon dioxide
Cyanosis:
Blue discoloration of the skin and mucous membranes
-late sign of hypoxia
Dysrhythmias:
deviation from the normal sinus heart rhythm
Lifestyle risk factors:
Smoking
Substance abuse
Stress
Smoking
- Associated with heart disease, COPD, and lung cancer
- The risk of lung cancer is 10 times greater for a person who smokes than for a nonsmoker.
Substance abuse
Excessive use of alcohol and other drugs impairs tissue oxygenation.
Stress
A continuous state of stress or severe anxiety increases the metabolic rate and oxygen demand of the body.
Myocardial ischemia:
results when the supply to the blood to the myocardium from the coronary arteries is insufficient to meet oxygen demands
Angina pectoris:
transient imbalance between myocardial oxygen supply and demand
Myocardial infarction (MI) or Acute coronary syndrome (ACS):
results from sudden decreases in coronary blood flow or increase in myocardial oxygen demand without adequate perfusion
The incidence of pulmonary disease is higher in
smoggy, urban areas than in rural areas.
Coccidioidomycosis:
fungal disease that can inhale spores
Asbestosis:
lead to lung cancer
Vaccinations
Influenza, pneumococcal
Environmental pollutants
Secondhand smoke, work chemicals, and pollutants
Dyspnea:
clinical sign of hypoxia, difficulty breathing
-anxiety, aspirin poisoning
Orthopnea:
patient uses multiple pillows when reclining to breath easier or sits leaning forward with arms elevated
Acute Care:
Hydration Humidification Nebulization Airway maintenence Chest physiotherapy Dyspnea managment Coughing, and deep breathing techniques Mobilization of pulmonary secretions
Humidification:
the process of adding water to gas
Nebulization:
adds moisture or medications to inspired air by mixing particles of varying sizeses with air
Spirometry:
- Helps a patient deep-breathe and prevent infection
- Lowers rates of postoperative pneumonia
- -Volume-oriented
Chest physiotherapy:
group of therapies for mobilizing pulmonary secretions
Postural drainage:
component of pulmonary hygiene
Oxygen therapy:
- To prevent or relieve hypoxia
- Early signs of hypoxia include anxiety, confusion, restlessness, and elevated blood pressure
- Used to treat diseases like pneumonia and chronic bronchitis
Safety precautions:
Oxygen is a medication
Supply of oxygen:
Tanks or wall-piped system
Methods of oxygen delivery:
- Nasal cannula
- Oxygen mask
Nasal cannula:
-Simple, effective, and comfortable
-Inexpensive and disposable
Oxygen tubing
Oxygen mask:
Simple face mask
Plastic face mask with reservoir bag
Face tent
Oxygen hood
Other types of oxygen delivery devices:
- Transtracheal oxygen cannula: cath insterted into trachea
- Partial nonrebreather mask with resovoir bag
- Nonrebreather with bag: has valve to prevent exhaled air from returning
- Venturi mask: delivers humidity
CPR:
- Circulation
- Airway
- Breathing
- Defibrillation (automatic external defibrillator [AED])
The nurse is caring for a patient who has decreased mobility. Which intervention is a simple and cost-effective method for reducing risks of stasis of pulmonary secretions and decreased chest wall expansion?
Frequent change of position - something the nurse can do without the doctor’s order
The nurse goes to assess a new patient and finds him lying supine (flat) in bed. The patient tells the nurse that he feels short of breath. Which nursing action should the nurse perform first?
Raise the head of the bed to 45 degrees - comfort first
Which intervention is appropriate for preventing atelectasis in the postoperative patient?
Incentive spirometer
