Physical Assessment: Oxygenation chp 37 Flashcards
(32 cards)
Oxygenation
- 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
What Systems Work Together to Achieve Oxygenation?
- Pulmonary
- Cardiovascular
- Musculoskeletal
- Neurological
The Musculoskeletal and Neurological Systems do what in Oxygenation?
regulate the movement of air into and out of the lungs
What do the Lungs do?
oxygenate the blood
What does the Heart Do?
circulates the blood throughout the body and back to the lungs
The Pulmonary System
-Airways + Lungs
>Ventilation
>Respiration
Ventilation
movement of air into/out of the lungs
Respiration
- exchange of oxygen/ carbon dioxide
- alveolar capillary/ capillary cell membrane
Normal Respiratory Status: Airway Patency
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
Normal Respiratory Status: Gas Exchange
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
Abnormal Airway Patency
Indicators:
- anxiety
- fear
- choking
- dyspnea
- cyanosis
- abnormal chest excursion
- tactile fremitus
- adventitious breath sounds
External Factors that Influence Pulmonary Function
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
Factors that Affect Ventilation
- respiratory rate and depth
- lung compliance
- lung elasticity
- airway resistance
Rate (respiratory)
how fast you breathe
Depth (respiratory)
how much your lungs expand to take in air
Lung Compliance
-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)
Lung Elasticity
(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
Airway Resistance
resistance to airflow within the airways
-the larger the diameter of the airway, the more easily air moves through it
Most Commonly seen CNS Problems in Adults
- Trauma
- Stroke
Abnormalities that Influence Pulmonary Function
- pulmonary system abnormalities
- pulmonary circulation abnormalities
- central nervous system (CNS) abnormalities
- neuromuscular abnormalities
Abnormal Gas Exchange
Indicators:
- dyspnea at rest
- dyspnea on exertion
- cyanosis
- somnolence (sleepiness)
- ABGs + pulse oximetry abnormal
Assessing Oxygenation Status
- breathing pattern
- respiratory effort
- assessing cough
- pulse oximetry
Respiratory Effort/ Dyspnea
- nasal flaring
- retractions
- grunting
- body positioning to facilitate respirations
- paroxysmal nocturnal dyspnea
- conversational dyspnea
- stridor
Respiratory Effort/ Dyspnea: Retractions
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
