Please enable JavaScript.
Coggle requires JavaScript to display documents.
Oxygenation (Definitions (alveoli - small air sacs at the end of the…
Oxygenation
Definitions
alveoli
- small air sacs at the end of the terminal bronchioles that are the site of gas exchnge
angina
- temporary imbalance b/w amount of oxygen needed by the heart and the amount delivered to the heart muscles
arterial blood gas
- diagnostic test examining arterial blood; used to determine pressure exerted by O2and CO2 in the blood
atelectasis
- incomplete expansion or collapse of a part of the lungs
atrioventricular bundle
- bundle of modified heart muscle that transmits the cardiac impulse from the atrioventricular node to the ventricles, causing them to contract
bradypnea
- slow rate of breathing
bronchial
- those heard over larynx and trachea are high-pitched, harsh "blowing" sounds with expiration longer than inspiration
bronchodilator
- medication that relaxes contractions of smooth muscles of the bronchioles
capnography
- method to monitor ventilation and, indirectly, blood flow to the lungs
crackles
- fine crackling sounds made as air moves through wet secretions in the lungs
dyspnea
- difficult or labored breathing
dysrythmia
- abnormal cardiac rhythm
endotracheal tube
- polyvinyl-chloride airway inserted through the nose or the mouth into the trachea, using a laryngoscope as a guide
hypoxemia
- deficient oxygenation of blood
hypoxia
- inadequate amount of oxygen available to cells
ischemia
- deficiency of blood in a particular area
nasal cannula
- disposable, plastic device that delivers oxygen via two protruding prongs for insertion into the nostrils
perfusion
- process by which oxygenated blood passes through body tissues
pulmonary ventilation
- movement of air into and out of lungs
pulse oximetry
- noninvasive technique that measures the oxygen saturation of arterial blood
spirometer
- instrument used to measure lung capacities and volumes; one type is used to encourage deep breathing (incentive spirometry)
sputum
- respiratory secretion expelled by coughing or clearing the throat
surfactant
- detergent-like phospholipid that reduces surface tension of the fluid lining the alveoli
tachypnea
- rapid rate of breathing
tracheostomy
- artificial opening made in the trachea through which a tracheostomy tube is inserted
wheezes
- continuous, high-pitched squeak or musical sound made as air moves through narrowed or partially obstructed airway passages
Factors Affecting
Level of Health
any acute and chronic illness -- significant correlation b/w obesity and COPD -- renal + cardiac disorders = fluid overload and impaired tissue perfusion -- poor muscles = lack of respiratory muscle ability -- ESPECIALLY CV diseases
Developmental Considerations
Older adults
less elasticity, reduced abdominal muscles = decline in max in and expiration
airways collapse more easily
blood vessels and valves less efficient
Children
@ risk for asthma d/t second hand smoke
less colds until school age, then exposure to pathogens builds up immunity
Infants
more rapid respiratory rate
aspiration is potential problem d/t small chest and short airways
Medication
drugs r/t CNS need to be monitored closely for respiratory complications (R&D can decrease w/ opioids, narcotics, sedatives)
Lifestyle
sedentary activity patterns
Environment
air pollution, occupational hazards
Psychological Health
hyperventilation during stress and anxiety decrease CO2 levels
bronchospasms from anxiety can lead to asthma attack
hypoxia can lead to anxiety
Learning Outcomes
Identify factors that influence and affect respiratory function
Describe nursing strategies to promote adequate oxygenation
Good nutrition
low in saturated fat, cholesterol, &salt -- high in fiber
rich in fruits, veggies, low-fat dairy, nuts, and legumes -- adequate intake of protein, vitamins, and minerals
decrease intake of fat, red meat, sweets, and sugary drinks
humidification to protect against irritation and infection
Coughing
helps clear airways of secretions and debris (secretions=sputum (phlegm)
dry cough = non-productive
Cough meds
expectorants = facilitate removal of secretions by reducing viscosity
suppressants = decrease cough reflex
lozenges = act on sensory and motor nerves to control cough
Chest physiotherapy - percussion, vibration, and postural drainage to increase mucus transport and expectoration
Suctioning airway - helps remove saliva, pulmonary secretion, etc. -- irritates mucosa and removes oxygen from resp. tract causing hypoxemia
Medicine
Bronchodilators - open narrowed airways
Mucolytic agents - liquefy or loosen thick secretions
corticosteroids - reduce inflammation in the airway
administered via nebulizer, metered-dose inhaler, or dry powder inhaler
Supplemental O2
plan, implement, and evaluate nursing care related to nursing diagnoses involving problems of oxygenation
Nursing Considerations
S&S of hypoxia
dyspnea
increased BP
increased pulse
pallor
cyanosis
anxiety, restlessness, confusion
drowsiness
often caused by hypoventilation or atelectasis
Chronis hypoxia
- altered thought processes, headaches, chest pain, enlarged heart, clubbing fingers and toes, anorexia, constipation, decreased urinary output, decreased libido, weakness of extremity muscles, and muscle pain
The Nursing Process
Focused Assessment
12-20 respiratory rate -- quiet and nonlabored
Pallor indicated less than optimal oxygenation -- Cyanosis indicates decreased blood flow/poor oxygenation
abnormal size or location of PMI or presence of vibrations can indicate heart failure, myocardial infarction, disease of heart valves, or other cardiac diseases
presence of decreased skin temperature, decreased pulses, and prolonged capillary refill indicate poor cardiac function and oxygenation
Auscultating
vesicular - low-pitched, soft sounds heard over peripheral lung fields
bronchial - loud, high pitched sounds heard over trachea and larynx
bronchovesicular - medium pitched blowing sounds over major bronchi
Cracking associated with inflammation or congestion associated w/ pneumonia, heart failure, bronchitis, and COPD
Wheezes caused by constricted airways d/t swelling, narrowing secretions, or tumors --indicative of asthma, tumors, or a buildup of secretions