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NURS 200 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

what is needed within the PROCESS OF OXYGENATION?

A
  • needs EFFECTIVE GAS EXCHANGE
    (from the lungs)
    **includes the EXCHANGE BETWEEN OXYGEN & CO2
  • needs EFFECTIVE PUMPING
    (from the heart)
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2
Q

definition of VENTILATION

A

movement of gases INTO AND OUT of the LUNGS
- the process of INHALATION & EXHALATION
- the SIMPLE ACT OF BREATHING

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3
Q

definition of DIFFUSION

A

the process for EXCHANGE OF RESPIRATORY GASES in the ALVEOLI (LUNGS) & CAPILLARIES (BODY TISSUE)

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4
Q

definition of RESPIRATION

A
  • the EXCHANGE OF OXYGEN & CO2 during cellular metabolism
  • is NOT THE ACT OF AIR MOVING IN AND OUT OF LUNGS
    • this is VENTILATION
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5
Q

what are the PHYSIOLOGICAL FACTORS THAT AFFECT OXYGENATION?

A
  • having DECREASED OXYGEN-CARRYING CAPACITY
  • HYPOVOLEMIA
  • DECREASED INSPIRED OXYGEN CONCENTRATION
  • INCREASED METABOLIC RATE
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6
Q

how can a patient have DECREASED OXYGEN-CARRYING CAPACITY?

A
  • the blood carries oxygen through HEMOGLOBIN
  • ex. ANEMIA -&raquo_space;LOW RBC/LOW HEMOGLOBIN&raquo_space; initiates a DECREASED OXYGEN-CARRYING CAPACITY
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6
Q

describe INCREASED METABOLIC RATE

A
  • needing an INCREASED METABOLIC RATE CAN AFFECT OXYGENATION
  • ex. EXERCISE & PREGNANCY
  • the necessity of greater resp. rate & a growing fetus
    = all these factors that INCREASE OXYGEN DEMAND
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6
Q

how can a patient have DECREASED INSPIRED OXYGEN CONCENTRATION?

A
  • want to look HOW MUCH AIR YOU ARE BREATHING FROM THE OUTSIDE

ex.
- UPPER/LOWER AIRWAY OBSTRUCTIONS
- HIGH ALTITUDES (have a decreased environmental O2)
- HYPOVENTILATION (respiratory rate is less than 12)
- having respiratory diseases or allergies (ex. ASTHMA or ALLERGIES–can be treated with steroids)

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7
Q

definition of HYPOVOLEMIA

A

where the body has very LOW VOLUME OF FLUIDS OR BLOOD
- often caused by either DEHYDRATION or LOSS OF BLOOD

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8
Q

definition of CARDIAC AFTERLOAD

A
  • having a HIGHER DIASTOLIC BLOOD PRESSURE
  • greater DIFFICULTY in PUMPING BLOOD or OVERWORKING THE HEART
  • have LOWER EJECTION OF THE VENTRICLES
  • necessity of MORE WORK THE HEART MUST DO
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9
Q

what are the CONDITIONS THAT AFFECT CHEST WALL MOVEMENT? (7)

A
  • PREGNANCY
    growing fetus
  • OBESITY
    reduced lung volumes/excess fat - greater pressure
  • MUSCULOSKELETAL ABNORMALITIES
    inadequate o2 delivery ex. pectus excavatum or scoliosis
  • TRAUMA
    abdominal surgeries/surgical incisions
  • NEUROMUSCULAR DISEASES
    lung or heart dystrophy
  • CNS ALTERATIONS
    mysathenia gravis or lupus
  • INFLUENCES OF CHRONIC LUNG DISEASE
    COPD or cystic fibrosis
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10
Q

hypoventilation

A

occurs when ALVEOLAR VENTILATION is INADEQUATE to meet the oxygen demand of the body or ELIMINATE SUFFICIENT CARBON DIOXIDE
- where we have LESS THAN 12 RESPIRATIONS
- pt can also be on NARCOTICS

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11
Q

hyperventilation

A

state of ventilation in which the lungs REMOVE CO2 faster than it is produced by CELLULAR METABOLISM
- build up of CO2; MORE THAN 20 RESPIRATIONS

ex. infections/fevers **increases metabolic demands – needs more oxygen
ex. cold weather
ex. exercising
ex. pain levels

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12
Q

hypoxia

A

INADEQUATE TISSUE OXYGENATION at the cellular level

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13
Q

difference between HYPOXIA and HYPOXEMIA

A

HYPOXIA
where we have LOW OXYGEN LEVELS in the body’s tissues
HYPOXEMIA
where we have LOW OXYGEN LEVELS in the body’s blood

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14
Q

what are some ALTERATIONS THAT CAN OCCUR IN CARDIAC FUNCTIONING?

A
  • disturbances in CONDUCTION
  • altered CARDIAC OUTPUT
    (left or right-sided heart failures)
  • IMPAIRED VALVULAR FUNCTION
  • MYOCARDIAL ISCHEMIA
  • ANGINA (chest pain)
  • MYOCARDIAL INFARCTION
    (death of the heart muscle cells)
15
Q

what are the DEVELOPMENTAL FACTORS THAT INFLUENCE OXYGENATION

A

INFANTS:
- protective function of maternal antibodies
- more at risk for URIs and airway obstruction
SCHOOL-AGE CHILDREN:
- unhealthy diets or stress, smoking, lack of exercise
- important for establishment of good habits
OLDER ADULTS:
- - calcification of heart valves
- increased left ventricular wall thickness
- impaired SA nodes

16
Q

what are some LIFESTYLE FACTORS THAT INFLUENCE OXYGENATION?

A
  • NUTRITION
    poor diet = more common with chronic lung diseases & resp muscle weakness
  • HYDRATION
    dehydration = decreased BP, decreased HR
  • EXERCISE
  • SMOKING
    vasoconstrictor of lungs
  • SUBSTANCE ABUSE
    drugs or way of diet = can depress respirations
  • STRESS
    increases respirations
17
Q

what are some ENVIRONMENTAL FACTORS THAT CAN INFLUENCE OXYGENATION?

A
  • type of OCCUPATION
  • where the person grew up
  • current surroundings
18
Q

what are some aspects to consider during assessment of NURSING HISTORY?

A
  • looking for any health risks
  • increase in respirations or pain
  • is the patient fatigued?
  • any dyspnea?
  • any coughing? is it productive or non-productive?
  • are they exposed to different environmental exposures
  • does the patient smoke?
  • any respiratory infections/allergies?
  • does the patient take any inhalers?
19
Q

what part of the PHYSICAL EXAMINATION is part of assessing OXYGENATION?

A
  • INSPECTION
    (want to observe skin, LOC, nails - capillary refill, RR)
  • PALPATION
    (pulses, tenderness, edema, temperature)
  • PERCUSSION
    (any volumes, air vs. fluid)
  • AUSCULTATION
    (listening for heart & lung sounds)
20
Q

skin color

A

does the patient have PALLOR? CYANOTIC?
NORMAL?

21
Q

mm

A

are they PALE/PINK? are they MOIST/DRY?

22
Q

what are SOME DIAGNOSTIC TESTS that can be done? (6)

A
  • TB
  • ECG
  • BLOOD WORK (CBC, HEMOGLOBIN/HEMATOCRIT)**can be an issue if Hb is in single digits
  • ABG; arterial blood gases - how much gas exchange is occurring + pH values
  • PFT; pulmonary fxn test; helps determine baseline of respirations
  • SPUTUM; determines TB/bacteria/pneumonia
23
Q

what are the appropriate NANDAS? (5)

A
  • IMPAIRED CARDIAC OUTPUT
  • ACUTE PAIN
  • ACTIVITY INTOLERANCE
    (dysthymia on exertion)
  • RISK FOR ACTIVITY INTOLERANCE
  • IMPAIRED AIRWAY CLEARANCE
    (cystic fibrosis pts.)
24
Q

what are some techniques for ACUTE CARE?

A
  • can help manage the pt’s DYSPNEA
  • use of proper EQUIPMENT and MEDICATIONS and OXYGEN ADMIN **always need an order
    *steroids, antibiotics
  • PROPER POSITIONING of PATIENT
  • SUCTIONING
  • HUMIDIFICATION
  • NEBULIZATION
  • proper COUGHING and DB EXERCISES
25
Q

describe CHEST PHYSIOTHERAPY

A
  • external chest wall manipulation using PERCUSSION, VIBRATION, or HIGH-FREQUENCY CHEST WALL COMPRESSION
  • POSTURAL DRAINAGE
  • overall helps to LOOSEN ANY DRAINAGE OR MUCUS
26
Q

why do we use ACUTE CARE?

A
  • want to increase POSITIVE EXPIRATORY PRESSURE (trying to get air behind all the mucus)
  • want to maintain LUNG EXPANSION
    ex. ambulation
    ex. positioning
    ex. incentive spirometry
27
Q

what are some ways for HEALTH PROMOTION of proper OXYGENATION?

A
  • having proper vaccinations
  • proper HEALTHY LIFESTYLE; eating right and regular exercise
  • awareness of any ENVIRONMENT POLLUTANTS
    *secondhand smoke, work chemicals or pollutants
28
Q

what are the types of SUCTIONING METHODS we have?

A
  • OROPHARYNGEAL & NASOPHARYNGEAL
  • OROTRACHEAL & NASOTRACHEAL
  • TRACHEAL
29
Q

what are some tips and factors to be aware of before SUCTIONING A PATIENT?

A
  • always allow the patient to be in an UPRIGHT POSITION
  • check their GAG REFLEX
  • check O2 STAT; suctioning can LOWER
  • check HR; suctioning can INCREASE
  • suction in INCREMENTS; 5-10 seconds
  • allow for VENTILATION PRIOR; PRE-OXYGENATE UR PATIENT if needed
30
Q

what are some OXYGEN PRECAUTIONS that we must be aware about?

A
  • make sure we have enough oxygen during transportation
  • oxygen is COMBUSTIBLE – NO SMOKING OR OPEN FLAMES
  • put EXTENSION TUBING for patients who need to move
31
Q

what are out METHODS OF OXYGEN DELIVERY?

A
  • NASAL CANNULA
  • HIGH FLOW NASAL CANNULA
  • OXYGEN MASKS

**4 L NEEDS HUMDIFICATION
**anything > 6 L; need to switch to a MASK OR HIGH FLOW

32
Q

incentive spirometry

A
  • type of HANDHELD PLASTIC DEVICE
  • want to take a DEEP BREATH; allows to EXPAND THE LUNGS
  • target goal; around 1000 mL
  • want to use it frequently to promote LUNG EXPANSION
33
Q

what are the TYPES OF BREATHING EXERCISES?

A
  • PURSED LIP BREATHING
  • DIAPHRAGMATIC BREATHING
34
Q

when are patients able to be assisted with HOME OXYGEN THERAPY

A

typically when the indication of pulse ox is < 88% seen during rest/exertion/exercise

NURS 200 (16 decks)

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