Oxygenation - Exam IV Flashcards
effect of age on ventilation
- infants and toddlers: at risk for URI when exposed to second hand smoke/other children (anatomically smaller airways at risk for obstruction)
- school aged/adolescents: at risk for infections from smoke
- older adults:less elastic chest wall and airways, decreased muscle strenth air exchange ciliary action, increased secretions remain in lunges
effect of age on gas exchange
- young and middle aged adults: at risk for cardiopulmonary issues because of unhealthy diet, lack of exercise, stress, drugs, smoking
- older adults: - osteoporosis leads to change in shape of the thorax, alveoli enlarge decreases the surface area for gas exchange
effect of age on perfusion
older adults: calcification of heart valves, vascular stiffening, atherosclerosis plaques,
effect of lifestyle on ventilation
- pregnancy: enlarging uterus pushes abdominal contents upward against the diaphragm
- obesity: morbidly obese have reduced lung volumes
- exercise increases metabolic activity and allows a person to inhale more O2 and let out excess CO2
- smoking is bad
- substance abuse: suppresses respiratory center = reducing rate =.depth of respiration
effect of lifestyle on gas exchange
nutrition: - good nutrition affects gas exchange by supporting normal metabolic functions
- smoking is bad
- substance abuse: poor nutritional intake results in decline in hemoglobin
effect of environment on ventilation
- trauma: rib fracture/bruising causes reduced ventilation
- smoking is bad
- rural populations likelier to have COPD related to smoking
effect of enviornment on gas exchange
- smoking is bad
- pts. workplace might be inhaling toxins
effect of environement on perfusion
inhalation of toxic substances decreases oxygen carrying capacity of blood by reducing the amount of hemoglobin available
- smoking is bad
effect of lifestyle on perfusion
hydration: fluid intake affects cellular health
- smoking is bad
effect of health on perfusion
anemia is the results of decreased hemoglobin production, and or blood loss
- smoking is bad
what medication interventions help promote respiratory factors and oxygenation
- vaccinations: flu vaccine, pneumococcla vaccine <2 yrs, Covid,
- bronchodilators, mucolytics, low-dose antianxiety meds
what inhalation therapies help promotes respiratory factors and oxygenation
- inhaled steroids,
- incentive spirometry
what oxygen therapies help promotes respiratory factors and oxygenation
noninvasive positive pressure ventilation: (CPAP and BiPAP)
Nasal Cannula, nonrebreather (keep reservoir bag inflated) , venturi mask, high-flow cannula,
what artifical airway interventions help promotes respiratory factors and oxygenation
Endotracheal airway
Tracheostomy
Nasopharyngeal adjunct airway
Oropharyngeal adjunct airway
what airway suctioning interventions help promotes respiratory factors and oxygenation
open : for sputum speciments, use of sterile catheter
closed: reusable sterile suction catheter - oxygn continued to be deliverd while suction performed
Invasive mechanical ventilation used with artifical airways
what diagnostic tests/examinations does the nurse do when a patient has impaired oxygenation
physical examination - inspection, palpation, auscultation
ABG
pulmonary function test
peak expiratory flow rate
bronchoscopy
lung scan
what diagnostic tests/examinations does the nurse do when a patient has impaired oxygenation
physical examination - inspection, palpation, auscultation
ABG
pulmonary function test
peak expiratory flow rate
bronchoscopy
lung scan
Thoracentesis
ABG - arterial blood gases
provides important information for assessment of patients respiratory and metabolic acid/base balance and adequacy of oxygenation
Thoracentesis
surgical perforation of chest wall/pleural space with a needle to aspirate fluid fir diagnosis identifies infection
ABG
pH: 7.35-7.45
pCO2: 35-45 mmHg
HCO3: 22-26 mEq/L
pO2: 80-100 mmHg
pulse oximetry
% hemoglobin saturated with O2
forced vital capacity
volume of air on forceful expiration
forced expuiratory volume
volume of air expired in 1 second after maximum inhalation
residual volume
amount of air remaining in the lungs after maximum expiration
peak expiratory flow rate
maximum speed of expiration , high numbers are best,
80-100%
<50% red
Endotracheal airway
- ET tube: short term, relieves obstruction, protects against aspiration, clear secretions, passes through vocal cords, baloon prevents aspirations
Nasopharyngeal adjunct airway
conscious or unconscious, sizing: tip of nose to earlobe
Oropharyngeal adjunct airway:
unconscious only, sizing: corner of mouth to angle of jaw
incentive spirometry
- flow-oirented
goal: inale slowly and deeply ; hold 2-6 seconds
slower inhalation = greater lung expansion
how would you know if the patients is getting enough o2 from the oxygenation therapy
- maintenance of patent airways
-SpO2 > 94%
-secretions are thing, clear - WBC returns to baseline
- decreased SOB
- clear breath sounds over all lung fileds
- no accessory muscle use
- able to engage ADLs without limitations
what are the signs and symptoms of hyperventilation
- rapid respiration, sighing breaths, numbness in hands/feet, light-headedness, loss of consiousness
what are the signs and symptoms of hypoventilation
(COPD) - pts have adapted to a high CO2 level to their receptors don’t function normally,
- respiroatry acidosis + arrest
- mental staus change, dysrhythmeias,, potential cardiac arrest,
if untreated: convulsions, unconsciousness, death
promote lung expnasion
position/ambulation
frequent psotions cahnges
IS
pursed lip breathing
chest tube
steps of care for pt. with altered o2
promote lung expanstion
mobilize secretions
ensure patent arway
adminsiter medications
patient education
early sings of hypoxia
apprehension, restlessness, inability to concentrates, deacrease level of consciousness, dizziness, and beahvioral changes, fatigues and agitated, increased pulse rate
late signs of hypoxia
lethargy, bradycardia, bradypnea, hypotension, cyanosis
Ensure patent airway
head and neck positioning
artifical airways
suctioning
mobilize secretions
deep breathing/coughing
hydration
humdified o2
suctioning posutral draining
