Nursing Fundamentals: Oxygenation Basic Concepts

To clear their airway, open alveoli to prevent atelectasis, and maintain good oxygen saturation levels

The oxygen level in the tank

To relieve inflammation and assist in opening air passages

<p>To clear secretions from the mouth and throat in patients who are unable to do so themselves</p> Signup and view all the answers

<p>Pain increases anxiety and metabolic demands, which increases the need for more oxygen supply</p> Signup and view all the answers

<p>To mobilize secretions and stimulate coughing to clear secretions out of the airway</p> Signup and view all the answers

<p>To decrease oxygen demand and allow patients to rest</p> Signup and view all the answers

<p>Respiratory depression</p> Signup and view all the answers

<p>Oxygenation equipment</p> Signup and view all the answers

<p>To identify and address underlying causes that may be contributing to worsening dyspnea</p> Signup and view all the answers

<p>The primary functions of the respiratory system are to provide oxygen to body tissues for cellular respiration, remove carbon dioxide, and help maintain acid-base balance.</p> Signup and view all the answers

<p>External respiration involves the diffusion of oxygen from the alveoli into the blood and the diffusion of carbon dioxide from the blood into the alveoli for exhalation.</p> Signup and view all the answers

<p>Internal respiration occurs between systemic capillaries and body cells/tissues, where oxygen diffuses into cells and carbon dioxide diffuses into the blood.</p> Signup and view all the answers

<p>Pulmonary capillaries facilitate the exchange of oxygen and carbon dioxide between the alveoli and the bloodstream.</p> Signup and view all the answers

<p>Maintaining acid-base balance is vital for normal body function, as it regulates pH levels influenced by carbon dioxide concentrations.</p> Signup and view all the answers

<p>Gas exchange at the cellular level is significant because it provides oxygen necessary for cellular respiration and removes carbon dioxide, a waste product.</p> Signup and view all the answers

<p>The major organs involved in gas exchange are the lungs, specifically the alveoli, where oxygen and carbon dioxide are exchanged.</p> Signup and view all the answers

<p>The respiratory system interacts with the cardiovascular system by delivering oxygen to the blood and removing carbon dioxide, which is transported back to the lungs.</p> Signup and view all the answers

<p>Dyspnea is the subjective feeling of not getting enough air, and its severity can lead to increased levels of anxiety in patients.</p> Signup and view all the answers

<p>Tachycardia is indicated by a heart rate above 100 beats per minute in adults at rest.</p> Signup and view all the answers

<p>An SpO2 reading below 92% may indicate hypoxia and requires prompt notification of the healthcare provider.</p> Signup and view all the answers

<p>The use of accessory muscles indicates respiratory distress as the patient struggles to breathe.</p> Signup and view all the answers

<p>The tripod position involves sitting up and leaning forward to enhance lung expansion and facilitate breathing.</p> Signup and view all the answers

<p>Cyanosis, or bluish changes in skin color and mucous membranes, is a late sign of hypoxia.</p> Signup and view all the answers

<p>The nurse should promptly call for assistance and initiate oxygen therapy as outlined in agency policy.</p> Signup and view all the answers

<p>The inability to speak in full sentences often indicates respiratory distress, as the patient may struggle to catch their breath.</p> Signup and view all the answers

<p>Raising the head of the bed promotes effective chest expansion and reduces the work of breathing for the patient.</p> Signup and view all the answers

<p>New confusion or a change in level of consciousness can signal hypoxia due to inadequate oxygen supply to the brain.</p> Signup and view all the answers

<p>A patient with a PaCO2 level of 48 mmHg is experiencing hypercapnia, which is an elevated level of carbon dioxide in the blood. While hypercapnia typically leads to changes in vital signs like tachycardia, dyspnea, and confusion, some patients may not show these changes initially. This is because the body can initially compensate for the increased CO2 by increasing respiratory rate and depth. However, as the hypercapnia progresses, the patient may become increasingly sedated or somnolent due to the CO2's effects on the brain. Additionally, the respiratory depth and rate may decrease as the body attempts to conserve energy due to the increasing respiratory effort required to expel the excess CO2.</p> Signup and view all the answers

<p>Hypoxia refers to a reduced level of tissue oxygenation, while hypoxemia specifically refers to decreased partial pressure of oxygen in the blood (PaO2). Hypoxemia is a type of hypoxia that occurs when the blood itself is deficient in oxygen, which then limits the oxygen available for tissues. Hypoxia, however, can occur due to various reasons, such as poor blood flow to tissues, even if the blood itself is well oxygenated. Both hypoxia and hypoxemia ultimately lead to reduced tissue oxygenation, which can cause harm to organs and systems that require a constant supply of oxygen for function.</p> Signup and view all the answers

<p>The normal range of pH for arterial blood is 7.35-7.45 because this range represents the optimal balance between acids and bases necessary for proper bodily function. A pH level below 7.35 is considered acidic and indicates a condition called acidosis, while a pH level above 7.45 is considered alkaline and indicates alkalosis. Acidosis and alkalosis can disrupt various bodily processes, including enzyme activity, cell function, and nerve impulse transmission, potentially leading to severe health complications.</p> Signup and view all the answers

<p>SaO2 and SpO2 both measure oxygen levels in the blood, but SaO2 is a calculated arterial oxygen saturation level, while SpO2 is a non-invasive measurement obtained using a pulse oximeter. They are similar in that they both provide an indication of oxygen saturation, but SaO2 is more accurate because it is not affected by factors such as poor perfusion, cool extremities, or carbon monoxide binding to hemoglobin, which can influence SpO2 readings.</p> Signup and view all the answers

<p>Bicarbonate (HCO3-) is a key buffer in the blood, meaning it helps to resist changes in pH. Increased bicarbonate levels contribute to alkalinity, making the blood less acidic. The kidneys play a vital role in regulating bicarbonate levels by retaining HCO3- to make the blood more alkaline and excreting HCO3- to make the blood less alkaline. This regulation ensures that the blood pH remains within the normal range, maintaining proper bodily function.</p> Signup and view all the answers

<p>Hypercapnia, or an elevated level of carbon dioxide in the blood, is primarily caused by hypoventilation, a decrease in the rate and/or depth of breathing. This can occur due to conditions affecting the respiratory system, such as lung disease or neuromuscular disorders, or factors like drug overdose. When hypoventilation occurs, carbon dioxide accumulates in the blood, leading to a decrease in pH, resulting in respiratory acidosis. Respiratory acidosis occurs because the excess CO2 reacts with water in the blood, forming carbonic acid, which increases the acidity of the blood.</p> Signup and view all the answers

<p>A patient with worsening hypercapnia may exhibit a range of symptoms, including increased sedation, somnolence, and decreased respiratory depth or rate. As the condition progresses, they may experience tachycardia, dyspnea, flushed skin, confusion, headaches, and dizziness. In severe cases, patients may become increasingly unstable and experience respiratory arrest, requiring immediate medical intervention.</p> Signup and view all the answers

<p>A patient with hypercapnia may have a normal SpO2 reading because the pulse oximeter primarily measures the oxygen saturation of hemoglobin in the blood. While hypercapnia indicates an increase in CO2 levels, it does not necessarily directly impact the oxygen-carrying capacity of hemoglobin. However, this normal SpO2 reading should not provide false reassurance because hypercapnia can still lead to severe complications such as respiratory arrest and decreased oxygen delivery to tissues. A normal SpO2 reading alone does not fully reflect the overall health status of a patient with hypercapnia.</p> Signup and view all the answers

<p>Hydrogen ions (H+) are acids that directly affect the acidity of the blood. Increased H+ levels increase acidity, while decreased H+ levels mean less acidity. Respiratory rate and depth play a critical role in regulating H+ levels. Increased respiratory rate and depth lead to increased CO2 expulsion, which reduces the formation of carbonic acid (H2CO3) and, consequently, reduces H+ levels, making the blood less acidic. Conversely, decreased respiratory rate and depth lead to CO2 retention, increasing carbonic acid formation and H+ levels, making the blood more acidic.</p> Signup and view all the answers

<p>Addressing the underlying cause of hypercapnia is crucial because hypercapnia can lead to serious complications, including respiratory arrest. Treatment options for hypercapnia are aimed at improving ventilation and reducing CO2 levels. Noninvasive positive pressure devices like BiPAP can help eliminate excess CO2. However, if these devices are not sufficient, intubation with an endotracheal tube and mechanical ventilation may be required. Other treatments may include addressing the underlying condition causing hypercapnia, such as treating respiratory infections or managing drug overdose.</p> Signup and view all the answers

<p>To ensure the patient is not breathing in too quickly.</p> Signup and view all the answers

<p>To prevent swallowing it, which can lead to infection or other complications.</p> Signup and view all the answers

<p>Three to five times every hour while awake.</p> Signup and view all the answers

<p>To push air out quickly with the mouth slightly open.</p> Signup and view all the answers

<p>To help break up mucus and create positive end-expiratory pressure (PEEP) in the airways.</p> Signup and view all the answers

<p>To encourage patients to use the device frequently and make it a habit.</p> Signup and view all the answers

<p>To keep the airways open and clear of mucus.</p> Signup and view all the answers

<p>Upright.</p> Signup and view all the answers

<p>It provides visual feedback and motivation to achieve a prescribed level of lung expansion.</p> Signup and view all the answers

<p>The nurse.</p> Signup and view all the answers

<p>Pursed-lip breathing helps control oxygenation and ventilation, reduces the feeling of shortness of breath, and improves gas exchange.</p> Signup and view all the answers

<p>Patients with obstructive sleep apnea frequently show symptoms like snoring and pauses in breathing during sleep, which may not be previously documented.</p> Signup and view all the answers

<p>Anxiety can exacerbate the sensation of dyspnea, making it more intense and difficult to manage, particularly in COPD patients.</p> Signup and view all the answers

<p>Untreated sleep apnea can lead to increased periods of apnea, hypoxia, and adverse health outcomes such as cardiovascular complications.</p> Signup and view all the answers

<p>Incentive spirometry is used to expand the lungs, keep alveoli open, and prevent fluid buildup and pneumonia after surgery.</p> Signup and view all the answers

<p>PEP therapy helps patients clear secretions and improve airway function in collaboration with respiratory therapists.</p> Signup and view all the answers

<p>Providers should look for signs such as snoring, pauses in breathing, and low oxygen saturation levels during sleep.</p> Signup and view all the answers

<p>Nurses can teach pursed-lip breathing, incentive spirometry, deep breathing, coughing techniques, and the huffing technique.</p> Signup and view all the answers

<p>Assessing anxiety is crucial as it can worsen dyspnea, and addressing it helps manage the overall patient experience and comfort.</p> Signup and view all the answers

<p>The nurse should document the findings and report them to the health care provider for further testing and potential intervention.</p> Signup and view all the answers

<p>The primary function of the oxyhemoglobin dissociation curve is to determine the percentage of hemoglobin bound to oxygen at various partial pressures of oxygen.</p> Signup and view all the answers

<p>The Bohr effect states that an increase in carbon dioxide concentration in the blood increases the release of oxygen from hemoglobin, making oxygen more available to tissues.</p> Signup and view all the answers

<p>The Haldane effect states that oxygenation of hemoglobin increases the affinity of hemoglobin for carbon dioxide, facilitating the transport of carbon dioxide from tissues to lungs.</p> Signup and view all the answers

<p>Pulse oximetry is a non-invasive method used to measure oxygen saturation levels in arterial blood, allowing for monitoring of oxygenation status in patients.</p> Signup and view all the answers

<p>The diaphragm is the primary muscle of inspiration, contracting to increase the volume of the thoracic cavity and decrease intrathoracic pressure, allowing air to enter the lungs.</p> Signup and view all the answers

<p>The respiratory system responds to changes in pH levels by adjusting ventilation rates to restore acid-base balance, with increased ventilation rates in response to acidosis and decreased ventilation rates in response to alkalosis.</p> Signup and view all the answers

<p>An incentive spirometer is a device used to encourage and measure deep breathing exercises, helping to improve lung function and prevent respiratory complications.</p> Signup and view all the answers

<p>Cyanosis is a bluish discoloration of the skin and mucous membranes due to inadequate oxygenation of the blood, caused by conditions such as respiratory or cardiovascular disease, or certain medications.</p> Signup and view all the answers

<p>Chest physiotherapy is a treatment used to promote clearance of mucus and secretions from the lungs, improving lung function and reducing the risk of respiratory complications.</p> Signup and view all the answers

<p>The Acapella device is a handheld, non-invasive device used to help loosen and clear mucus and secretions from the lungs, promoting effective coughing and improving lung function.</p> Signup and view all the answers

<p>Pulse oximetry relies on the amount of hemoglobin saturated with oxygen. Factors like anemia (reduced hemoglobin levels), poor peripheral circulation (reduced blood flow to extremities), or the presence of substances like carbon monoxide that can bind to hemoglobin can interfere with the accuracy of the reading. A normal SpO2 reading might not indicate adequate oxygenation if these factors are present.</p> Signup and view all the answers

<p>Ventilation, or the process of breathing, is directly related to PaCO2. When ventilation decreases, the body's ability to expel carbon dioxide through exhalation is impaired. This leads to a buildup of carbon dioxide in the bloodstream, resulting in an elevated PaCO2 level.</p> Signup and view all the answers

<p>PaO2 represents the amount of dissolved oxygen in the arterial blood, directly reflecting how efficiently oxygen is transferred from the lungs into the bloodstream. Unlike SpO2, which measures the percentage of hemoglobin saturated with oxygen, PaO2 is not affected by hemoglobin levels and provides a more accurate assessment of oxygenation status in cases of anemia or other conditions affecting hemoglobin.</p> Signup and view all the answers

<p>Patients with COPD have long-term lung damage that hinders their ability to exchange gases efficiently. Their bodies may adapt to lower oxygen levels, and pushing for higher SpO2 readings could strain their respiratory system. A lower target range helps maintain a balance between adequate oxygenation and minimizing respiratory distress.</p> Signup and view all the answers

<p>Carbon dioxide is transported in the blood by three mechanisms: dissolved in plasma, bound to water as bicarbonate ions (HCO3-), and attached to hemoglobin. Dissolved CO2 represents a small portion, while bicarbonate ions account for the majority. Hemoglobin, though primarily for oxygen transport, also carries some CO2, aiding in its removal from tissues to the lungs for exhalation.</p> Signup and view all the answers

<p>Hemoglobin, a protein found in red blood cells, is responsible for carrying oxygen throughout the body. Each hemoglobin molecule can bind to four oxygen molecules. Oxygenation status refers to the amount of hemoglobin saturated with oxygen. A higher saturation level indicates a greater capacity for oxygen delivery to tissues.</p> Signup and view all the answers

<p>Carbon dioxide, when dissolved in blood, forms carbonic acid, which contributes to blood acidity. An increase in PaCO2 leads to a decrease in blood pH (more acidic). Conversely, a decrease in PaCO2 results in a higher blood pH (more alkaline). This relationship is crucial in assessing respiratory status, as changes in PaCO2 reflect the body's ability to regulate acid-base balance through ventilation.</p> Signup and view all the answers

<p>ABG provides a more comprehensive and accurate measurement of oxygenation status by directly assessing the partial pressure of oxygen (PaO2), carbon dioxide (PaCO2), pH, and bicarbonate levels in arterial blood. Pulse oximetry, while non-invasive and convenient, only measures the percentage of hemoglobin saturated with oxygen (SpO2) and is susceptible to inaccuracies due to factors like anemia or poor circulation. ABG is more invasive but offers a more precise and complete picture, while SpO2 is readily available but may not reflect true oxygenation in certain situations.</p> Signup and view all the answers

<p>The respiratory system plays a crucial role in maintaining acid-base balance by regulating the removal of carbon dioxide, a key contributor to blood acidity. Through ventilation, the lungs expel carbon dioxide, reducing the production of carbonic acid in the blood. Increased ventilation leads to a decrease in PaCO2 and a higher blood pH (more alkaline), while decreased ventilation results in an increase in PaCO2 and a lower blood pH (more acidic).</p> Signup and view all the answers

<p>SpO2 refers to the percentage of hemoglobin in the blood that is saturated with oxygen. It's a non-invasive way to assess how well the lungs are delivering oxygen to the blood. The typical target range for healthy adults is 94-98%. In patients with chronic conditions like COPD, the target range may be lower, often 88-92%, as their bodies may have adapted to lower oxygen levels. The specific target range is determined by the healthcare provider based on the individual patient's condition.</p> Signup and view all the answers