Oxygenation Flashcards
Tachypnea
Rapid shallow respiratory rate/breathing 
Hyperpnea
Rapid respiratory rate with increased depth
Bradypnea
Slow respiratory rate
Orthopnea
Discomfort when breathing while laying down
Hyperventilation
Increased rate or depth of respirations causing an alveolar ventilation that is above the body’s normal metabolic requirements
Hypoventilation
Decreased rate or depth of respiration causing alveolar ventilation that is less than the body’s requirements
Perfusion
+ usually referring to rate at which blood is delivered to tissues
+ Passage of fluid through the circulatory system to an organ or tissue
Respiration
Inhalation and exhalation – primarily to take up oxygen to deliver through pulmonary capillaries
Ventilation
Process of moving air in and out of lungs
Describe bullet points of oxygen
+21% of normal air
+ tasteless, odorless, colorless gas
+ considered a medication – must be ordered by HCP
Clinical application and significance of oxygen
+ Must be ordered by an HCP + in situations with a clear clinical indication such as decreasing oxygen saturation, tachypnea, emergency, the absence of a prescription should not delay the administration of oxygen to the patient
What is hypoxia
Inadequate amount of oxygen available to cells – low levels of oxygen in body tissues
What is “air hunger” + causes
+ Caused by low levels of oxygen in air or by disease
+ Caused by COPD, emphysema, asthma, anemia, CHF, pneumonia, bronchitis, pneumothorax, PE, sleep apnea
+ ANY condition that reduces amount of oxygen in your blood or restricts blood flow - ie. High altitude
Regional and generalized affects of hypoxia
+ Hypoxia causes blood vessels in the pulmonary circulation to go under marked vasoconstriction
+ Regional – one area of the lungs directs blood flow away from the hypoxic area
+ Generalized – causes vasoconstriction throughout the lungs
Early symptoms of hypoxia – most common
+ Tachycardia + irritable + restless + tachypnea + dyspnea + labored breathing + cool, clammy
+ ABGs 60-80
+ headache
+ agitation
+ confusion
+ BP: systolic increases diastolic decreases
+ Pulse increases, bounding, pressure widening
+ respirations rapid
Late signs and symptoms of hypoxia
+ Bradycardia + increasing dyspnea and tachypnea, possible bradypnea or agonal breathing
+ ABG is less than 60
+ Cyanosis + brain swelling + seizures + lethargy + nasal flaring
+ Using accessory muscles
Nursing interventions for breathing and oxygenation issues
+ ASSESS – quality of breath, using accessory muscles, skin color
+ raise head of bed, sit them up
+ check oxygen orders
+ SBAR HCP
How to assess cough
+ Productive/non-productive
+ effective/ineffective
+ needs assistance
+ description – raspy, dry, barking, painful, seductive, absent cough reflex
How to assess sputum/phlegm
Color, character, amount, odor
How to assess dyspnea
+ Difficulty breathing ➡️ subjective to patient
+ Feeling short of breath during ADLs
+ perception of difficulty breathing and reaction to that sensation
+ Note: LOC, RR, nasal flaring, accessories muscle usage
Hemoptysis - definition
Blood in lungs + bright red usually + blood and sputum
How to assess hemoptysis
+ Bloody sputum, usually bright red
+ note source – forceful cough
+ presence of TB, cancer, pneumonia, chronic bronchitis
How to assess cyanosis
+ + blue or gray color to skin + Note LOC
+ heart or lung disease presence
+ inadequate respiration
+ check earlobes, lips, mucous membranes, nail beds, palms of hands and feet
3 adventitious breath sounds
 Crackles, wheezes, rhonchi
Explain crackles
+ WET - usually on inspiration
+ NOT CLEARED BY COUGH
+ Fine crackles — high-pitched discontinuous intermittent popping sounds + course – low pitched
+ discontinuous
+ air passing through fluid and airways, usually lower
+ Pneumonia, COPD, bronchitis, heart disease, many more
Explain wheezes
+ Continuous musical sounds on inspiration or expiration
+ usually louder – expiration
+ air through constricted swollen airways + asthma, COPD
Explain rhonchi
+ Low pitched snoring – rumbling coarse snore
+ movement of fluid and secretions in larger airways
+ may clear with coughing or suctioning
+ COPD, chronic bronchitis, cystic fibrosis
PFT - pulmonary function test
+ Evaluates lung function, airwaves traction through respiratory mechanics
+ spirometry – measures the volume of air in liters exhaled or inhaled
+ peak expiratory flow rate —PEFR — point of highest flow during forced expiration
Explain pulse oximetry
+ Measures arterial oxygen hemoglobin saturation of arterial blood
+ used to evaluate patient’s hemoglobin level before evaluating oxygen saturation
+ Attaches to finger but can be attached earlobes
Thoracentesis – explain
Needle in the pleural cavity – fluid is drawn out and analyzed
Bronchoscopy – explain
Tube inserted into lungs through nose down back of throat – used to look at lungs with a camera
Factors that affect respiratory function
+ Illness
+ lifestyle
+ environment
+ gerontologic
+ medication’s
+ psychologic
Nursing interventions and implementations for oxygen and breathing
+ Education
+ reduce anxiety
+ positioning
+ humidified air
+ incentive spirometry
+ diaphragmatic breathing
+ deep breathing
+ pursed lip breathing
+ coughing
+ fluid intake increased
+ chest physiotherapy
+ oxygen administration
+ suctioning
+ inhalants
+ medications
Which oxygen apparatus is most precise way of delivering 02
Venturi mask — Deliver 6 to 10 L per minute
Which oxygen apparatus delivers the highest concentration of O2 with its delivery method
Nonrebreather mask — delivers 6 to 15 L per minute
Changes in older adults respiratory system
+ Chest tissues and airways become less elastic
+ reduction in power of respiration and abdominal muscles
+ less diaphragmatic movement, less efficient
+ decrease in maximum inspiration and expiration
+ airways collapse easily
+ high risk for pneumonia and other respiratory infections
+ fewer alveoli
+ thickened walls of alveoli
+ Decrease gas exchange and increase work of breathing
+ decreased ventilation and ineffective cough
+ decreased cardiac output and ability to respond to stress
Which oxygen delivery system provides the lowest flow rate
Nasal cannula – 1 to 6 L per minute
Which “oxygenation “nursing intervention promotes relaxation and gets rid of CO2 
Pursed lip breathing!
