Oxgenation Flashcards
Pulmonary ventilation
Movement of air into and out of the lungs
Inspiration and expiration
Respiration
Gas exchange between the atmospheric air in the alveoli and blood in capillaries
Perfusion
Oxygenated capillary blood passes through the body tissue
Mechanism of altercation in oxygenation
Musculature condition
Lung elasticity and compliance
Airways resistance
Musculature condition
When there is wreaking of the muscles that are involved in respiration it can cause less effective exhalation and inhalation
Lung compliance
The ease at which the lungs can be inflated
The ability of the ,bugs to full with air during inhalation is achieved with normal elasticity and is aided by surfactant
A stiff lung requires greater effort to inflate it
Airways and resistance
Any process that changes the bronchial diameter or width can cause airway resistance.
Obstruction
: foreign object, secretion, tissues
Inflammation of airway
Surface area available
If someone has a piece of their lung removed there will be decreased surface area
Thickening of the alveolar capillary membrane
Someone with history of smokingm or respiratory disease
The body is not able to distinguish which concentration is high or low
Hypoxemia
This is when there is lower than normal oxygen in the blood
What are the common causes of hypoxemia
Anemia
Acute respiratory distress syndrome
COPD
Pneumonia
Pulmonary edema
Emphysema
Pneumonia and hypoxemia
Pneumonia causes inflammation to the lungs air sacs leading to swelling and accumulation of fluids and the formation of pus. This impaired oxygen uptake
Pulmonary edema and hypoxemia
With pulmonary edema there is a fluid buildup in the alveoli that hinders the exchange of oxygen from the air sacs to the blood stream.decrease oxygen intake
Emphysema and hypoxemia
This is when the lung tissue gradually gets damaged. Loses function and the loses ability to perform gas exchange
Hypoxia
Inadequate amount of oxygen in the cells
Hypoxia occurs when there is a problem with?
Problem with ventilation, respiration or perfusion
Clinical manifestations of hypoxia
Dyspnea: difficulty breathing
Increase blood pressure and the heart is working harder
Increased respiratory rate
Increased pulse rate form the heart working harder
Pallor
Cyanosis
Anxiety
Restlessness
Confusion
Drowsiness
Risk factors affecting oxygenation
Level of health
Developmental considerations
Medication
Lifestyle
Environment
Normal respiratory rate for infant (birth to 1)
30-60
Res rate for early childhood
20-40
Res rate for late childhood
15 to 25
Infants
The chest wall is very small
30-60 bpm
They use accessory muscles to breathe
Toddlers, preschoolers, school aged children, and adolescents
They have increased risk for respiratory illness
Respiratory rate start to stabilize
Older adults
They have decried lung elasticity which is normal
Shallow breathing
Assessment techniques
Patient history
Interview
Assessment guide
Physical assessment
Labs and diagnostic
How do you conduct a physical assessments
Inspect, palpation, percussion and auscultate
Lab and diagnostic
Pulmonary function test
Common diagnosis
Patient history
Interview and to identify
Current health issues
Potential health problems
Actions to meet respiratory needs
Aids used to improve ventilation
Effect on lifestyle and relationship
What actions that are performed by the patient to meet respiratory needs should be concerning
If the patient needs to raise the head of the bed
The head needs to be elevated
Sitting up to sleep
What are some aids to ventilation questions
Oxygen
How many liters
Do they use it all the time
What are the normal breath sounds
Vesicular
Bronchial
Brinchovesicular
Vesicular . Where is it heard mostly
This is low pitched and soft on inspiration being longer than expiration
Heard mostly over lungs
Bronchial. Where is it mostly heard
High pitched and sounds on expiration being longer than inspiration
Over trachea
Bronchovesicular. Where is it heard
Medium itched and sound with inspiration equal to expiration
Over the mainstream bronchus
Abnormal breath sounds
Crackles
Rhonchi
Wheezes
Crackles
Intermittent popping sounds occurring when air moves through airways that have fluid
Sound like someone is opening a bag of chips
Pulmonary edema
CHF
Rhonchi
Course snoring quality, continuous sounds when air is passing through or around secrets
Pneumonia
Wheezes
Musical whistling sounds as air passes through airway constricted by narrowing swelling secretions or tumors
Asthma
COPD
Emphysema
Tumor
Spirometry
Measures volume of air inhaled or exhales by patient over time
Peak expiratory flow rate
Determine if there is a airway constriction
Pulse oximerty
95-100%
Measures arterial oxygenation saturation
Arterial blood gas and pH analysis
Measures the adequacy of oxygenation
Electrocardiography
Measures the heart electrical activity
Pulmonary function studying
Assess the respiratory function
Pulse oximetry
Measures the arterial oxygenation saturation
Cryptologic study
Detects malignant cells and infectious organism
Endoscopic studies
Visualizes airway
Skin test
Identifies the exposure to disease
Radiography
Help diagnose and termite progress or pulmonary disease
Lung scan
Measures the integrity of airway and detect ventilation abnormalities
Capnogrhy
Method to monitor ventilation. Blood flow through the lungs
Thoracentesis
Picturing the chest wall and aspirate the pleural fluid
Altercations in respiratory functioning problem
Ineffective airways clearance r/t secretion in bronchi
Impaired gas exchange r/t alters oxygen supply
Ineffective breathing pattern r/t pain
Altercations in respiratory functioning as the etiology
Activity intolerance related to SOB
Anxiety related to impaired gas exchange
Acute pain related to pleural inflammation
What are the expected outcomes
Patient will demonstrate improved gas exchange in lungs by absence of cyanosis and pulse oximetry reading of 95% or greater.
Demonstrate self care behavior that provide relief for, symptoms and prevent further cardiopulmonary problems
Relate causative factors if known and demonstrate a method of coping with these factors
Nursing and collaborative interventions
Suction airway
Medicine
Supplemental oxygen
Using artificial arirways
Managing chest tubes
What is the main goal
To promote optimal functioning of cardiopulmonary systems, promote comfort, promote and control cough
Nursing interventions to promote comfort
Positioning
Maintain adequate fluid intake
Providing humidified air
Positioning
Use a position that allows free movement of the diaphragm and expansion of the chest wall.
Which position is best for better breathing for patients who have Dyspnea and orthopnea
High Fowlers position
Sitting in a slumped position
Permit the abdominal content to push upward in the diaphragm and decrease lung expansion during inspiration
Maintain adequate fluid intake
Help loosen up secretions
Drink at least 1.5 to 2 liters
Providing humidified air
Inhalation if dry air removes the normal moisture in the respiratory tract
Water vapor creates moisture into the air
Promote proper breathing
Deep breathing
Incentive spirometry
Pursed lips
Diaphragm breathing
Deep breathing
Increases the amount of air enters the lungs more oxygen
Helps with Hypoventilation
Incentive spirometry
Provides visual reinforcement when deep breathing
Sustain maximal inhalation
Pursed lips breathing
Patient who experience shortness of breath
Prolong the expiration and prevent collapse of the airway
Diaphragmatic breathing
COPD and Dyspnea
Slow down a persons breathing and help them catch their breath
Belly breathing
Sit upright or lie on their back on a flat surface with knees bent and pillow under knees. Hand on stomach and the other in middle of chest
Promoting and controlling cough
Voluntary cough
Involuntary cough
Cough medication
Teach about medicine
Voluntary coughing
Teach the patient this for pre and post operative care
Rise and remove secretion that is built up overnight
Involuntary coughing
Often accompanies respiratory tract infection and irritations and lead to the production or respiratory secretion which trigger a cough
It can be fatiguing and irritating
Productive vs non productive cough
Productive cough is when you cough and something comes up
Non productive cough is when nothing comes up
Types of cough medication
Expectorant
Suppressant
Lozenges
Expectorants
Help with the removal of respiratory tract secretion
Give to patient with thick secretion
Makes nonproductive cough become productive
Suppressants
If a patient have an irritable nonproductive cough without congestion they can be given a suppressant help sleep
Cough suppressant with a productive cough
If productive cough is suppressed then the secretion can be retained causing pulmonary infection
Lozenges
Soothes the throat
Relieve mild nonproductive cough
Think sore throat
Teaching about medication
Can be detrimental to those with hypertension, thyroid or cardiac disease
Prolong use of cough medication can cause more serious problem
More than 6 days to see doctor
Teach about suppressant vs expectorant
Suctioning airway
To maintain patient airway and remove saliva, pulmonary secretion, blood etc from pharynx.
Pre oxgentate the patient before suction
Orally or from the nares or tracheostomy
The patient is able to raise from the airways but unable to clear from mouth
Medication intervention To improve respiratory function
Bronchodilator
Mucolytic agent
Corticosteroid
Bronchodilator
Open the airway that is narrowed
Narrow passage cause wheezing
Emphysema
Mucolytic agents
They liquify or loosen thick liquids
Corticosteroids
Reduce inflammation in airway
Emphysema
Administered via nebulizers
Bronchodilator
Metered dose inhaler
Dry power inhaler
Nasal cannula: low flow
A maximum of 6 liters
Check frequently to make sure that the prongs are placed properly in the nares
Simple mask: low flow
5-8 liters
Check to make sure mask is placed correctly
No breather mask: low flow
10-15 liters
Check the valves and rubber flaps
Maintain the rate so that the reservoir bag collapses only slightly during inspiration
Venturi mask: high flow
4-6 liters
What is important to remember when giving oxygen
You must have an order
Precautions with oxygen
Keep at least 6 feet away from any source of fire
No smoking
No electrical equipment near the tank
Secure the tank in a holder away from heat or sunlight
Avoid oils in the area
Have working smoke detectors
Working fire extinguisher
Administering oxygen
Follow the prescription for the oxygen
Ensure that there is enough when leaving the house
Know the signs and symptoms
Have healthcare providers number
Healthy lifestyle
Activity and mobility increases your cardiac output and respiratory
So when you are such the body is already used to the high demand making you recover well
Vaccinations
Older adults is at high risk
Covid, pneumonia, flu
Pollution free environment
Occupations such as nail tech and construction workers
Minimize anxiety
Medulla controls breathing
High stress causes Hypoventilation not adequately perfusion
Marinating good nutrition
Healthy lifestyle
Foods low in fat
Who might pursed lip breathing be good for
Patient with dyspnea
It imporove gas exchange
And avoid narrowing of the airway
