Oxygenation Study Guide
 Review
 Oxygen is needed to sustain life.
 Blood is oxygenated through ventilation, perfusion, and transport of respiratory gases.
 Neural and chemical regulators control the rate and depth of respiration.
 Cardiovascluar Anatomy and Physiology
 Chambers of the heart
 Right and left atria
 Right and left ventricles
 Heart Valves
 Semilunar valves
 Pulmonic
 Aortic
 Atrioventricular valves (A-V)
 Tricuspid
 Mitral
 Cardiac Output
 CO = SV x HR
 ___________Volume (SV)
 Volume of blood ejected by the ventricles in one cardiac cycle
 Heart Rate (HR)
 Number of cardiac cycles in one minute
 Respiratory Physiology
 Factors Affecting Oxygenation
 Physiological factors
 Decreased oxygen-carrying capacity
 Decreased inspired oxygen
 Hypovolemia
 Increased metabolic rate
 Conditions affecting chest wall movement
 Pregnancy
 Obesity
 Musculoskeletal abnormalities
 Trauma
 Neuromuscular disease
 CNS alterations
 Alterations in Cardiac
Functioning
Disturbances in conduction
Altered cardiac output
Caused by electrical impulses that
do not originate from the SA node
(dysrhythmias)
Insufficient volume is ejected into the
systemic and pulmonary circulation
Impaired valvular function
Myocardial ischemia
Is acquired or congenital disorder
of a cardiac valve by stenosis or
regurgitation
Coronary artery flow to the
myocardium insufficient to meet
myocardial oxygen demands
 Alterations in Respiratory Functioning
Hyperventilation
Hypoventilation
Ventilation in excess of that required to
eliminate carbon dioxide produced by
cellular metabolism
Alveolar ventilation inadequate to meet the
body’s oxygen demand or to eliminate
sufficient carbon dioxide
RR>20 adults
RR<12 adults
Hypoxia
___________________
Inadequate tissue oxygenation at the cellular
level
Blue discoloration of the skin and mucous
membranes
 Developmental Factors
 Infants and toddlers
 School-age children and adolescents
 Young and middle-age adults
 Older adults
 Lifestyle Risk Factors
 Nutrition
 Exercise
 Smoking cessation
 Substance abuse
 Stress reduction
 Assessment: Nursing History
Pain
Smoking
Dyspnea
Cough
Wheezing
Environmental/geographical exposures
Respiratory infections
Allergies
Health risks
Medications
 Physical Examination
 Inspection
 Palpation
 Percussion
 Auscultation
 Diagnostic Tests
Blood tests
 CBC
 Cardiac enzymes
 Serum electrolytes
 Cholesterol
X-rays
 Chest x-ray
 Cardiac catheterization
Noninvasive
 TB skin test
 Holter monitor
 ECG
 Thallium stress test
 EPS
 PFT
 Nursing Diagnosis and Planning
 Develop cardiopulmonary nursing diagnoses based on specific assessment data.
 Individualized client outcomes and goals are identified to help clients meet their needs.
 Examples:
 Impaired gas exchange
 Fatigue
 Ineffective air clearance
 Implementation: Health Promotion
 Vaccinations
 Influenza, pneumococcal
 Healthy lifestyle
 Eliminate risk factors, eat right, regular exercise
 Environmental pollutants
 Second-hand smoke, work chemicals, and pollutants
 _____________ Management
 Airway management
 Mobilization of pulmonary secretions
 Humidification
 Nebulization
 Chest physiotherapy
 Suctioning
 Oropharyngeal and nasopharyngeal
 Used when the client can cough effectively but is not able to clear secretions
 Orotracheal and nasotracheal
 Used when the client is unable to manage secretions
 Tracheal
 Used with an artificial airway
 Artificial Airways
 Oral airway
 Prevents obstruction of the trachea by displacement of the tongue into the oropharynx
 _________________ airway
 Short-term use to ventilate, relieve upper airway obstruction, protect against aspiration, clear
secretions
 Tracheostomy
 Long-term assistance, surgical incision made into trachea
 Maintenance and Promotion of Lung Expansion
 Positioning
 Reduces pulmonary stasis, maintains ventilation and oxygenation
 Incentive spirometry
 Encourages voluntary deep breathing
 Chest tubes
 A catheter placed through the thorax to remove air and fluids from the pleural space or to prevent air
from reentering or to reestablish intrapleural and intrapulmonic pressures
 Maintenance and Promotion of Oxygenation
 Oxygenation therapy
 To prevent or relieve hypoxia
 Methods of supply
 Nasal cannula
 thin tube with two small nozzles that protrude into the patient's nostrils
 Low rates
 Oxygen mask
 Simple
 between 6 and 12 LPM
 ______________________
 accurately deliver a predetermined oxygen concentration to the trachea up to 40%.
 Non-Rebreather
 featuring a reservoir bag, which increases the provided oxygen rate to 40–70% oxygen at 5 to
15 LPM
 Restoration of Cardiopulmonary Functioning
 Cardiopulmonary resuscitation
 Circulation
 Airway
 Breathing
 CAB now instead of ABC
 Defibrillation
 Restorative and Continuing Care
 Cardiopulmonary rehabilitation
 Hydration
 Coughing techniques
 Purse Lipped-Breathing
 Diaphragmatic breathing