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Nursing 171 > Physical Assessment: Oxygenation chp 37 > Flashcards

Physical Assessment: Oxygenation chp 37 Flashcards

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1
Q

Oxygenation

A
  • the pulmonary, cardiovascular, musculoskeletal and neurological systems work together to achieve oxygenation
  • the musculoskeletal and neurological systems regulate the movement of air into and out of the lungs
  • the lungs oxygenate the blood
  • the heart circulates the blood throughout the body and back to the lungs
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2
Q

What Systems Work Together to Achieve Oxygenation?

A
  • Pulmonary
  • Cardiovascular
  • Musculoskeletal
  • Neurological
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3
Q

The Musculoskeletal and Neurological Systems do what in Oxygenation?

A

regulate the movement of air into and out of the lungs

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4
Q

What do the Lungs do?

A

oxygenate the blood

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5
Q

What does the Heart Do?

A

circulates the blood throughout the body and back to the lungs

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6
Q

The Pulmonary System

A

-Airways + Lungs
>Ventilation
>Respiration

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7
Q

Ventilation

A

movement of air into/out of the lungs

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8
Q

Respiration

A
  • exchange of oxygen/ carbon dioxide

- alveolar capillary/ capillary cell membrane

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9
Q

Normal Respiratory Status: Airway Patency

A 
Airway Patency = open, clear tracheobronchial passages for air exchange
Indicators:
-ease of breathing
-moves sputum out of airway
-moves blockage out of airway
-respiratory rate WNL
-rhythm WNL
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10
Q

Normal Respiratory Status: Gas Exchange

A 
alveolar exchange of carbon dioxide and oxygen to maintain arterial blood gas concentrations
Indicators:
-cognitive status WNL
-ease of breathing WNL
-arterial blood gases WNL
-pulse oximetry WNL
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11
Q

Abnormal Airway Patency

A

Indicators:

  • anxiety
  • fear
  • choking
  • dyspnea
  • cyanosis
  • abnormal chest excursion
  • tactile fremitus
  • adventitious breath sounds
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12
Q

External Factors that Influence Pulmonary Function

A

the adequacy of ventilation is affected by the rate and depth of respirations, lung compliance and elasticity, and airway resistance

  • lifespan + development
  • environment (stress + allergies)
  • lifestyle (nutrition, exercise, substance abuse)
  • medications
  • smoking; current use/ history
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13
Q

Factors that Affect Ventilation

A
  • respiratory rate and depth
  • lung compliance
  • lung elasticity
  • airway resistance
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14
Q

Rate (respiratory)

A

how fast you breathe

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15
Q

Depth (respiratory)

A

how much your lungs expand to take in air

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16
Q

Lung Compliance

A

-ease of lung inflation
-lungs normally inflate easily
Reduced by:
>increased lung water (edema)
>loss of surfactant
>conditions that cause elastin fibers in the lungs to be replaced with scar tissue (collagen)

17
Q

Lung Elasticity

A

(elastic recoil)

  • tendency of elastin fibers to return to their original position away from the chest wall after being stretched (think of stretching a rubber band, then letting go of it)
  • alveoli that have been overstretched, as with emphysema, lose their elastic recoil over time
18
Q

Airway Resistance

A

resistance to airflow within the airways

-the larger the diameter of the airway, the more easily air moves through it

19
Q

Most Commonly seen CNS Problems in Adults

A
  • Trauma

- Stroke

20
Q

Abnormalities that Influence Pulmonary Function

A
  • pulmonary system abnormalities
  • pulmonary circulation abnormalities
  • central nervous system (CNS) abnormalities
  • neuromuscular abnormalities
21
Q

Abnormal Gas Exchange

A

Indicators:

  • dyspnea at rest
  • dyspnea on exertion
  • cyanosis
  • somnolence (sleepiness)
  • ABGs + pulse oximetry abnormal
22
Q

Assessing Oxygenation Status

A
  • breathing pattern
  • respiratory effort
  • assessing cough
  • pulse oximetry
23
Q

Respiratory Effort/ Dyspnea

A
  • nasal flaring
  • retractions
  • grunting
  • body positioning to facilitate respirations
  • paroxysmal nocturnal dyspnea
  • conversational dyspnea
  • stridor
24
Q

Respiratory Effort/ Dyspnea: Retractions

A

the visible “pulling in” of intercostal, supra-clavicular, and subcostal tissue
-caused by negative pressures generated in the chest to try to increase depth of inhalation

25
Q

Respiratory Effort/ Dyspnea: Paroxysmal Nocturnal Dyspnea

A

sudden awakening due to shortness of breath that begins during sleep
-the patient feels panic and extreme dyspnea and must sit upright to ease breathing

26
Q

Respiratory Effort/ Dyspnea: Conversational Dyspnea

A

inability to speak complete sentences without stopping to breathe
-the more frequently the patient pauses when speaking, the more severe the dyspnea

27
Q

Respiratory Effort/ Dyspnea: Stridor

A

a high-pitched harsh, crowing, inspiratory sound caused by partial obstruction of the larynx or trachea
-can hear it without a stethoscope

28
Q

Assessing Oxygenation Status: Diagnostic Testing

A

> Arterial Blood Gases (ABGs)
-PO2, PCO2

> Peak Flow Monitoring
-monitors amount of air that can be exhaled with forcible effort

29
Q

Interventions for Optimal Oxygenation

A

Promoting Respiratory Function:

  • Immunizations/ prevent URI’s
  • Positioning
  • Aspiration precautions
  • Administering respiratory medications
  • Use of a mechanical ventilator
  • Use of a chest tube drainage system
  • Support smoking cessation
30
Q

Incentive Spirometer

A

will enable patient to monitor depth of his breathing (abdominal or chest incisions may require pain meds before use)

  1. Breathe out normally
  2. Place mouthpiece in mouth and create a seal with lips
  3. Breathe in slowly and as deeply as possible through mouthpiece
  4. Hold your breathe for as long as possible, at least to a slow count of 3
  5. Remove mouthpiece from mouth + exhale
31
Q

Interventions for Optimal Oxygenation: Mobilizing Secretions

A
  • Deep breathing and coughing
  • OOB as soon as possible after surgery
  • Daily OOB to chair orders
  • Hydration
32
Q

Interventions for Optimal Oxygenation: Oxygen Therapy

A

-cannula
-mask
-humidify inhaled air
>provides oxygen at concentrations greater than the level found in room air
>room air contains only 21% oxygen
>requires medical prescription for dosage and route

Nursing 171 (38 decks)

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