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3802- Oxygenation
Oxygenation
| Question | Answer |
|---|---|
| How is oxygen carried in blood? | 1. Dissolved in plasma (1-3%) 2. In chemical combination with hemoglobin |
| Atelectasis | collapse of the alveoli, prevents normal exchange of oxygen and carbon dioxide |
| Aspiration | an inflammatory condition of the lungs and bronchi caused by inhaling foreign materials or vomitus |
| Hyperventilation | a state of ventilation in excess of that required to eliminate the normal carbon dioxide produced by cellular metabolism |
| Signs of hyperventilation (5) | 1. (too) deep and / or rapid breathing 2. numbness or tingling of fingers and around the mouth 3. blurred vision 4. disorientation 5. dizziness/ light- headedness |
| Causes of hyperventilation (4) | 1. anxiety 2. infections/ fever/ pain 3. drugs 4. acid- base imbalance (diabetic ketoacidosis) |
| Nursing Interventions for hyperventilation (5) | 1. Monitor vitals (especially respiratory rate and depth) and pulse oximetry 2. Determine the cause 3. Instruct to breathe slowly and less deeply 4. Administer sedatives as ordered 5. Provide emotional support to decrease anxiety |
| Hypoventilation | Hypoventilation occurs when alevolar ventilation is inadequate to meet the body’s oxygen demand |
| Signs of hypoventilation (3) | 1. Shallow and/or slow breathing 2. Lethargy 3. Dizziness, disorientation |
| Causes of hypoventilation (3) | 1. Depression of the central respiratory drive (drugs, sedatives) 2. Atelectasis (often seen post- op) 3. Inappropriate administration of excessive oxygen to COPD patients |
| Nursing interventions for hypoventilation (5) | 1. check and maintain airway 2. position patient in Fowler's position 3. Monitor vitals and pulse oximetry (especially respiratory rate and depth) 4. Determine the cause 5. Administer supplemental oxygen as ordered |
| Hypoxemia | abnormal deficiency of oxygen in the arterial blood |
| Hypoxia | inadequate tissue oxygenation at the cellular level; can result from a deficiency in oxygen deliver or oxygen utilization at the cellular level |
| Signs of hypoxia (4) | 1. apprehension, restlessness 2. confusion, inability to concentrate, change in mental state 3. declining level of consciousness 4. cyanosis (late sign) |
| Causes of hypoxia (6) | 1. low hemoglobin level 2. low concentration of inspired oxygen 3. inability of the tissues to extract oxygen from blood 4. low diffusion of oxygenation from alveoli to blood 5. poor tissue perfusion with oxygenated blood 6. impaired ventilation |
| Nursing interventions for Hypoxia | 1. monitor vitals and continuous pulse oximetry to assess for increases or decreases in blood oxygen levels 2. administer oxygen as ordered to increase arterial oxygen pressure 3. monitor level of consciousness 4. withhold sedatives 5. monitor RBCs |
| Dyspnea | difficulty breathing that causes anxiety; shortness of breath |
| Normal breathing rate | 15- 20 breaths per minutes |
| Tachypnea | fast breathing, greater than 24 breaths per min |
| Bradypnea | less than 10 breaths per min |
| Apnea | period of no respiration |
| Oximetry | 1. Non-invasive 2. Measures SpO2 and heart rate 3. Normal results are greater than 95 4. Readings can be intermittent, continuous, or during ambulation 5. Trend more important than 1 reading |
| Arterial blood gases | 1. Invasive, painful 2. Blood sample drawn from radial artery by respiratory therapist 3. Gives info about arterial oxygen saturation, acid- base disturbances 4. Includes PaO2, PaCO2, acidity (pH) in arterial blood, PaHCO3 |
| What are normal values for ABGs? | 1. pH 7.35- 7.45 2. PaO2 80-100 mm Hg 3. PaCo2 35-45 mm Hg 4. SaO2 greater than 95% 5. HC03 22- 26 mEq/L |
| Evaluate pH for ABGs | pH elevated- suspect alkalosis pH decreased- suspect acidosis |
| Evaluate PaCO2 for ABGs | PaCO2 decreased- suspect respiratory alkalosis PaCO2 elevated- suspect respiratory acidosis (CO2 is an acid) |
| Evaluate HCO3 | HCO3 decreased- suspect metabolic acidosis HCO3 increased- suspect metabolic alkalosis |
| Respiratory acidosis | 1. pH- below 7.35 2. PaCO2- above 45 3. HCO3- normal 4. Example- hypoventilation |
| Respiratory alkalosis | 1. pH- above 7.45 2. PaCO2- below 35 3. HCO3 normal 4. Example: hyperventilation |
| Orthopnea | inability to breath comfortably laying flat |
| Hemoptysis | coughing up blood |
| Hematemesis | vomiting blood |
| Epistaxis | nosebleed |
| Pneumonia | inflammation of the lung prenchyma caused by a microbial organism |
| What are normal hemoglobin levels? | Male: 13.5- 18 g/dl; Female: 12-16 g/dl |
Created by:
indriushka
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