Oxygenation Flashcards
Process of Oxygenation
Ventilation – process of moving gases into and out of the lungs (oxygen and carbon dioxide).
Diffusion – exchange of respiratory gases in the alveoli and capillaries.
Perfusion – ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs.
Alterations in Respiratory functioning
Hypoventilation - occurs when alveolar ventilation is inadequate to meet oxygen demand of the body or eliminate sufficient carbon dioxide.
Hyperventilation - state of ventilation in which lungs remove carbon dioxide faster than its produced cellular metabolism.
Hypoxia - inadequate tissue oxygenation at the cellular level.
Factors Affecting Oxygenation
Physiological Factors:
DHDI
• Decreased Oxygen-Carrying Capacity
• Hypovolemia (low fluids)
• Decreased Inspired Oxygen Concentration
• Increased Metabolic Rate
Conditions Affecting Chest Wall
Movement:
POMTINC
• Pregnancy
• Obesity
• Musculoskeletal Abnormalities
• Trauma
• Neuromuscular Diseases.
• Central Nervous System Alterations
• Influences of Chronic Disease
Symptoms of Hypoxia
Early
R - Restlessness
A - Anxiety
T - Tachycardia / Tachypnea
Late
B - Bradycardia
E - Extreme Restlessness
D - Dyspnea
In pediatrics
F - Feeding difficulty
I - Inspiratory Stridor
N - nares flare
E - Expiratory grunting
S - Sternal Retraction
Alterations in Cardiac Functioning
DAIM
- Disturbances in conduction
- Altered cardiac output
- Impaired Valvular Function
- Myocardial Ischemia (Heart attack)
Lifestyle factors of oxygenation
NHESSS
- Nutrition
- Hydration
- Exercise
- Smoking
- Substance Abuse
- Stress
Major Health Hazard that can be hiding in your walls
Asbestos
Nursing History
• Health Risk
• Pain
• Fatigue
• Dyspnea
• Cough
• Allergies
• Medications
• Smoking
• Respiratory Infections
Nursing Diagnosis in alteration of oxygenation
ADFIIIR
• Activity Intolerance
• Decreased Cardiac Output
• Fatigue
• Impaired Gas Exchange
• Ineffective Airway Clearance
• Ineffective Breathing Pattern
• Risk for Aspiration
Dyspnea Management
POPP
- pharmacological measures
- oxygen therapy
- physical techniques
- psychosocial techniques
What oxygen therapy
Supplemental oxygen
Oxygen Delivery Systems
Nasal cannula (prongs) - 1-6 L/min (24-44%)
Oxygen mask - 6-12 L/min (35-50%)
Partial and non rebreather masks - 10-15 L/min (60-90%)
Venturi mask - 24-50% (may irritate skin) (have different venturi valves)
Tracheostomy Collar - attaches to neck
Oxygen Safety
- never use o2 near open flame
- never use o2 near cigarettes
- never use grease or oil with o2 equipment
- o2 promotes combustion
- do not tamper with o2 equipment
- store in cool place
- store o2 lying flat, securely fasten if upright
- use only medical o2
- do not use when delivering a shock via a defibrillator
Technique that involves laying/ sitting in
certain positions to drain secretions from airways using gravity.
Postural Drainage
Adds moisture or medications to inspired air. Delivers bronchodilators and mucolytic agents.
Nebulization
Acute Care
DAMHHNCC
- Dyspnea Management
- Airway Maintenance
- Mobilization of Pulmonary Secretions
- Hydration
- Humidification
- Nebulization
- Coughing and Deep-Breathing Techniques
- Chest Physiotherapy
Coughing exercises
Quad Cough Technique - for patients without abdominal muscle control (spinal cord injuries)
Maintenance and Promotion of Lung Expansion
APIN
- Ambulation
- Positioning
- Incentive Spirometry
- Non-Invasive Ventilation
Position for COPD or severe respiratory distress
Tripod Position
Incentive Spirometry
• Sustained Maximal Inspiration Device (SMIs)
Maintenance of Ventilation
Invasive-Mechanical Ventilation (positive pressure ventilation) - ventilator associated pneumonia
Noninvasive Ventilation - (Non invasive positive pressure ventilation) NPPV
- CPAP (continuous positive airway pressure) - fixed pressure
- BiPAP (positive pressure ventilation) - used to facilitate breathing, delivers higher pressure
Prevents or treats atelectasis by inflating alveoli and reducing pulmonary edema
NPPV - Non invasive positive pressure ventilation
Artificial Airways
- Oral Airways
- Nasal Airways
- Endotracheal Tube
- Tracheal Airway
Inserted through the nares, terminating the oropharynx
Nasopharyngeal Airways
Surgically created stoma in trachea to make airway
Trachestomy
Chest Tube and Drainage Systems
- Pneumothorax - air collects in the pleural space.
- Hemothorax - accumulation of blood in the pleural space.
- Pleural effusion - excessive fluid in the pleural space.
Drainage system
PLEUR-EVAC
Airway Maintenance
SCN
Suctioning
Chest Physiotherapy
Nebulizer Therapy
stimulates a natural cough reflex.
Effective for clearing central
airways.
Huff cough
Measure the flow of air inhaled through the mouthpiece are used to
ICLEF
-improve pulmonary ventilation
-counteract the effects of anesthesia or hypoventilation
-loosen respiratory secretions
-facilitate respiratory gaseous exchange
-expand collapsed alveoli
