Oxygenation Power Point Flashcards by Leigh Rothgeb

______ is needed to sustain life.

Oxygen

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The ____ and respiratory systems supply the oxygen demands of the body.

cardiac

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The exchange of respiratory gases occurs between the _____ and the blood.

environment

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_____ is the exchange of oxygen and carbon dioxide during cellular metabolism.

Respiration

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_____- and chemical regulators control the rate and depth of respiration in response to changing tissue oxygen demands.

Neural

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The pressure in the pleural cavity is always ______. Less than atmospheric pressure of 760 mmHg at sea level.

negative

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Negative pressure between the ______ membranes is what keeps the lungs always partially expanded

pleural

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Respiration is the exchange of oxygen and carbon dioxide during _______.

cellular metabolism

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The airways of the lung transfer oxygen from the atmosphere to the _____, where the oxygen is exchanged for carbon dioxide.

alveoli

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Through the ______ membrane, oxygen transfers to the blood, and carbon dioxide transfers from the blood to the alveoli.

alveolar capillary

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________ is the effort required to expand and contract the lungs.

Work of breathing

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______ active process stimulated by chemical receptors in the aorta.

Inspiration

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______ passive process that depends on the elastic recoil properties of the lungs, requiring little or no muscle work.

Expiration

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_______ 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

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_______ Collapse of the alveoli that prevents the normal exchange of oxygen and carbon dioxide.

Atelectasis

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An active process stimulated by chemical receptors in the aorta; a passive process for expiration

Inspiration =

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Lung volumes: tidal, residual, forced vital capacity (FVC); spirometry are needed for diagnosis of _____ and other respiratory diseases.

asthma

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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

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______ 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

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_____ 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

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____ sense changes in the chemical content and stimulate neural regulators to adjust.

chemoreceptors

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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

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End-diastolic pressure is also called ____

preload

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Resistance to left ventricular ejection is known as _____.

afterload

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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