Oxygenation Power Point Flashcards
______ is needed to sustain life.
Oxygen
The ____ and respiratory systems supply the oxygen demands of the body.
cardiac
The exchange of respiratory gases occurs between the _____ and the blood.
environment
_____ is the exchange of oxygen and carbon dioxide during cellular metabolism.
Respiration
_____- and chemical regulators control the rate and depth of respiration in response to changing tissue oxygen demands.
Neural
The pressure in the pleural cavity is always ______. Less than atmospheric pressure of 760 mmHg at sea level.
negative
Negative pressure between the ______ membranes is what keeps the lungs always partially expanded
pleural
Respiration is the exchange of oxygen and carbon dioxide during _______.
cellular metabolism
The airways of the lung transfer oxygen from the atmosphere to the _____, where the oxygen is exchanged for carbon dioxide.
alveoli
Through the ______ membrane, oxygen transfers to the blood, and carbon dioxide transfers from the blood to the alveoli.
alveolar capillary
________ is the effort required to expand and contract the lungs.
Work of breathing
______ active process stimulated by chemical receptors in the aorta.
Inspiration
______ passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work.
Expiration
_______ Chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing. A reduction in the chemical surfactant causes atelectasis.
Surfactant
_______ Collapse of the alveoli that prevents the normal exchange of oxygen and carbon dioxide.
Atelectasis
An active process stimulated by chemical receptors in the aorta; a passive process for expiration
Inspiration =
Lung volumes: tidal, residual, forced vital capacity (FVC); spirometry are needed for diagnosis of _____ and other respiratory diseases.
asthma
The thickness of the alveolar capillary membrane _____ diffusion and exchange of respiratory gases. It also decreases delivery of oxygen to tissues which can result in pneumonia, pulmonary infiltrates and ________.
slows
pulmonary edema
______ regulation takes place in the Central nervous system since it controls the respiratory rate, depth, and rhythm. The cerebral cortex regulates the _____ control of respiration.
Neural
voluntary
_____ regulation Maintains the rate and depth of respirations based on changes in the blood concentrations of CO2 and O2, and in hydrogen ion concentration (pH)
chemical
____ sense changes in the chemical content and stimulate neural regulators to adjust.
chemoreceptors
Cardiopulmonary physiology involves delivery of deoxygenated blood (blood high in carbon dioxide and low in oxygen) to the right side of the heart and then to the lungs, where it is ____.
oxygenated
End-diastolic pressure is also called ____
preload
Resistance to left ventricular ejection is known as _____.
afterload
Physiologic Factors Affecting Oxygenation
Cardiac disorders
Respiratory disorders: hypo and hyperventilation, hypoxia
Alterations is chest wall movement: trauma, collapsed lung
Decreased oxygen-carrying capacity affects oxygenation
Anemia- lower than normal hemoglobin
Decreased hemoglobin production
Increased red blood cell destruction
Blood loss
Significant blood loss, adaptation by peripheral vasoconstriction
HR X SV = CO
Inhalation of toxic substances (CO): also called functional anemia
Oxygenation safety guidlines
Patients with sudden changes in their vital signs, level of consciousness, or behavior are possibly experiencing profound hypoxia.
Perform tracheal suctioning before pharyngeal suctioning whenever possible.
Use caution when suctioning patients with a head injury.
The routine use of normal saline instillation into the airway before ET and tracheostomy suctioning is not recommended.
The most serious tracheostomy complication is airway obstruction, which can result in cardiac arrest.
Patients with COPD who are breathing spontaneously should never receive high levels of oxygen therapy.
Focus on evaluating how the disease is affecting _____ activities and how the patient believes he or she is responding to treatment.
day-to-day
Compare the patient’s actual progress to the goals and expected outcomes of the nursing care plan to determine his or her _______
health status
Evaluation
Ask about
Degree of breathlessness
If distance ambulated without fatigue has increased
Rating the breathlessness from 0 to 10
Which interventions reduce dyspnea
Frequency of cough and sputum production
Perform
Observe respiratory rate before, during, and after any activity.
Assess any sputum produced.
Auscultate lung sounds for improvement in adventitious sounds.
Aerosol Mask or Face Tent
24-100% FiO2
Flow Rate at least 10L/min
Requires Humidification
Drain Condensation from tubing often
Venturi Mask
24-50% FiO2
Flow rate 4-10 L/min using adapters
Deliver most precise oxygen
Nonrebreather Mask
Nonrebreather Mask
80-100% FiO2
Flow rate 10-15 L/min
Keep reservoir bag 2/3 full on inspriation and expiration
Delivers highest O2 concentration except intubation
Partial Rebreather Mask
Partial Rebreather Mask
40-70% FiO2
Flow rate 6-10 L/min
Keep reservoir 1/3 to ½ full on inspiration
Oxygen Delivery
40-60% FiO2
Flow rate 5-8L/min
Minimum flow rate 5L/min
Nasal Cannula
24-44% FiO2
Flow rate 1-6 L/min
Humidification > 4L/min
Oxygen therapy is used to prevent or relieve _____.
hypoxia
Supply of oxygen is located in tanks or ______.
in wall piped system
Methods of oxygen delivery
Nasal cannula
Oxygen mask
Factors that affect Oxygenation includes Hypovolemia which can result in _____ and dehydration which leads to ECF loss & circulating blood volume
shock
Factors that affect Oxygenation
Decreased inspired oxygen concentration (FIO2) which leads to ….
Decreased inspired oxygen concentration (FIO2)
Decreased oxygen carrying opportunity
Upper & Lower Airway Obstruction
Decreased environmental oxygen such as in High altitudes
Hypoventilation such as in drug overdoses
Factors affecting oxygenation include ____ metabolic rate that increases the demand for oxygen.
increased
Increased oxygen demand from increased metabolic rate can result from pregnancy, wound healing, exercise, and _____.
fever
Fever increases the need of tissues for ______.
oxygen
With increased oxygen demand carbon dioxide production ___________. The body attempts to adapt to increased carbon dioxide levels by increasing the rate and depth of respiration.
increases
Increased metabolic demand increases ________ and decreases muscle mass.
muscle wasting
Increased metabolic demand causes a decrease of _______: diaphragm and intercostal muscles.
respiratory muscles
Conditions Affecting Chest Wall Movement
Pregnancy
Obesity
Neurotransmitter disease
musculoskeletal abnormalities
Pregnancy - condition affecting the chest wall movement
Inspiratory capacity decreases especially late in pregnancy
Fetus pushes abdominal contents against diaphragm
Obesity - conditions affecting chest wall movement
Reduced lung volumes from heavy lower thorax and abdomen
Neuromuscular disease - conditions affecting chest wall movement
Decreased ability to expand and contract chest wall.
Myasthenia gravis, Guillain-Barre syndrome causes hypoventialtion
Musculoskeletal abnormalities - conditions affecting chest wall movement
Muscular Diseases
Abnormal structural configurations of rib cage such as kyphosis, scoliosis, lordosis.
Trauma
Flail chest or multiple rib fractures: Contract on inspiration and bulge on expiration, resulting in hypoxia
Factor affecting oxygenation include _____ or thoracic surgery.
abdominal
* Be careful of shallow respirations to avoid pain**
Decreases chest wall movement
_________ to treat pain
Depresses respiratory center
Decreases respiratory rate
Decreased chest wall expansion
OPIOIDS
CNS alterations affect oxygenation such as trauma of the _________ and/or spinal cord. Damages phrenic nerve, diaphragm does not descend, decreased chest wall expansion
medulla oblongata
Factors that affect oxygenation include influences of chronic diseases such as _____ which can result in barrel chest.
COPD
Respiratory Wellness - Age Related Changes
- Increased stiffness of chest wall
- Increased anteroposterior diameter
- Enlarged aveoli
- Weaker respiratory muscles
- Decreased response to hypercapnia or hypoxia
Respiratory Wellness - negative function
Increased use of accessory muscles
- Decreased cough and gag reflexes
- Increased energy expenditure for breathing
- Decreased efficiency of gas exchange
- Increased susceptibility to respiratory infections
Cardiovascular Wellness in Older adults - Age related Changes
Myocardial degenerative changes
Arterial stiffening
Increased peripheral resistance
Altered baroreflex mechanisms
Cardiovascular Wellness in Older adults - Negative Functional Consequences
- Decreased adaptive response to exercise
- Increase susceptibility to hypertension, hypotension
- Increased susceptibility to arrhythmias
- Decreased cerebral blood flow
_________ is ventilation in excess of that required to eliminate carbon dioxide produced by cellular metabolism
Hyperventilation
_____ is Inadequate tissue oxygenation at the cellular level.
hypoxia
Blue discoloration of the skin and mucous membranes. Late sign of hypoxia known as _____.
cyanosis
______ is when alveolar ventilation inadequate to meet the body’s oxygen demand or to eliminate sufficient carbon dioxide
hypoventilation
The goal of ventilation is to produce a normal arterial carbon dioxide tension (PaCO2) between ____ and _____ mm HG
35-45 mm Hg
The goal of ventilation prodcue a normal arterial oxygen tension (PaO2) between ______ and ______.
80and 100 mmHg
Hypoventilation and hyperventilation are determined by ________.
arterial blood gas analysis
Hypoxemia refers to a decrease in the amount of arterial oxygen. Monitored with pulse oximeter to obtain arterial oxygen saturation (SpO2), which is normally greater than __.
95%
Diets rich in fiber; whole grains; fresh fruits and vegetables; nuts; antioxidants; lean meats; and omega-3 fatty acids.
Cardioprotective nutrition
People who exercise for 30 to 60 minutes daily have a lower pulse rate and blood pressure, decreased cholesterol level, increased blood flow, and greater oxygen extraction by working muscles.
Exercise
Lifestyle Risk Factors for oxygenation
smoking
substance abuse
stress
Smoking is associated with heart disease, ____, and lung cancer.
COPD
The risk of lung cancer is ____ times greater for a person who smokes for a nonsmoker.
10 times
Excessive use of alcohol and other drugs impairs tissue _____.
oxygenation.
A continuous state of stress or severe anxiety increases the metabolic rate and oxygen demand of the body.
stress
A continuous state of stress or severe anxiety increases the metabolic rate and oxygen demand of the body.
stress
The incidence of _____ disease is higher in smoggy, urban areas than in rural areas.
pulmonary
A patient’s ________ sometimes increases the risk for pulmonary disease.
workplace
i.e. Coccidioidomycosis
Asbestosis
_______ lose the elastic recoil of the lungs and thorax. this increases the work of breathing.
COPD
________ in COPD patients results in hyperventilation
Excessive Oxygen Therapy
______ is adapted to increased carbon dioxide levels because the CO2 sensitive
COPD
COPD is sensitive to ______ oxygen, which increases ventilation, so stimulus to breathe is decreased oxygen level.
decreased
Oxygen administration greater than 24% to 28% FIO2 (1 to 3L/min), prevents oxygen level from falling, (to a level of 60 mm Hg), thus destroying stimulus or drive to breathe in ______ patients
COPD
Emphysema is the destruction and enlargement of ______ in the lungs.
air spaces
Emphysema is the destruction and enlargement of ______ in the lungs.
air spaces
An assessment is a in-depth history of a patient’s normal and present cardiopulmonary function and includes.
past impairments in circulatory or respiratory functioning
methods that a patient uses to optimize oxygenation
Review of drug, food, and other allergies
Physical examination
Laboratory diagnostic tests
During an oxygenation assessment
find out about the follwoing chest pain dyspnea wheezing respiratory infection health risks fatigue cough smoking allergies medications environmental/geographical exposures
During the physical examination your perform _____ where you observe the Skin and mucous membranes, level of consciousness (LOC), breathing patterns, chest wall movement
inspection
During the physical examination your perform ____ on the chest, feet, legs, pulses.
palpation
During the physical examination your perform _____ which senses for the presence of abnormal fluid or air; diaphragmatic excursion
percussion
