Nursing Fundamentals: Oxygenation Basic Concepts

The respiratory system provides oxygen to body tissues for cellular respiration and removes carbon dioxide.

External respiration involves the diffusion of oxygen from the alveoli into the blood and carbon dioxide from the blood into the alveoli.

Internal respiration is the exchange of gases between systemic capillaries and body cells, where oxygen enters cells and carbon dioxide enters capillaries.

<p>The cardiovascular system transports oxygen via blood, while the hematological system ensures adequate red blood cell levels for oxygen binding.</p> Signup and view all the answers

<p>Alveoli are essential for gas exchange as they provide a large surface area for oxygen to diffuse into the blood and carbon dioxide to diffuse out.</p> Signup and view all the answers

<p>Carbon dioxide is a waste product of cellular respiration that must be expelled from the body to maintain homeostasis.</p> Signup and view all the answers

<p>Major organs include the lungs, trachea, bronchi, and alveoli.</p> Signup and view all the answers

<p>The respiratory system regulates the levels of carbon dioxide, which affects the pH of the blood, thus helping maintain acid-base balance.</p> Signup and view all the answers

<p>Pulmonary ventilation provides air to the alveoli, which is essential for the gas exchange process.</p> Signup and view all the answers

<p>Rhonchi are low-pitched, continuous sounds heard on expiration caused by turbulent airflow through mucus in the large airways.</p> Signup and view all the answers

<p>The systemic circuit transports oxygenated blood to body tissues and returns deoxygenated blood to the heart.</p> Signup and view all the answers

<p>Rales are popping sounds on inspiration caused by fluid accumulation, while wheezes are whistling sounds on expiration due to narrowed airways.</p> Signup and view all the answers

<p>Cardiac output refers to the amount of blood the heart pumps in one minute, essential for maintaining adequate perfusion.</p> Signup and view all the answers

<p>Pleural rub sounds are caused by inflammation of the pleura membranes and can be heard on both inspiration and expiration.</p> Signup and view all the answers

<p>The right atrium receives deoxygenated blood, while the left atrium receives oxygenated blood, pushing it into the ventricles.</p> Signup and view all the answers

<p>Conditions such as asthma, pneumonia, and heart failure can significantly hinder ventilation.</p> Signup and view all the answers

<p>Bronchoconstriction narrows airways, causing wheezing sounds due to turbulent airflow during expiration.</p> Signup and view all the answers

<p>In the pulmonary circuit, blood picks up oxygen and releases carbon dioxide as it travels to and from the lungs.</p> Signup and view all the answers

<p>Abnormalities in the respiratory, cardiovascular, or hematological systems</p> Signup and view all the answers

<p>Partial or full collapse of the airway as muscles relax during sleep</p> Signup and view all the answers

<p>Anxiety can worsen dyspnea and is often chronically undertreated</p> Signup and view all the answers

<p>To decrease dyspnea by controlling oxygenation and ventilation</p> Signup and view all the answers

<p>To expand the lungs, keep alveoli open, reduce fluid buildup, and prevent pneumonia</p> Signup and view all the answers

<p>In collaboration with a respiratory therapist</p> Signup and view all the answers

<p>It reduces air trapping by creating a small amount of positive end-expiratory pressure (PEEP) in the airways</p> Signup and view all the answers

<p>To improve overall respiratory function and quality of life</p> Signup and view all the answers

<p>To improve oxygenation and ventilation</p> Signup and view all the answers

<p>By teaching enhanced breathing and coughing techniques, such as pursed-lip breathing and incentive spirometry</p> Signup and view all the answers

<p>Severe anemia reduces the amount of hemoglobin available to carry oxygen, leading to a lower SpO2 reading even if the lungs are functioning normally.</p> Signup and view all the answers

<p>PaO2 reflects the partial pressure of dissolved oxygen in the blood, unaffected by hemoglobin levels, while SpO2 measures the percentage of hemoglobin saturated with oxygen. In anemia, SpO2 may be lower due to reduced hemoglobin, even if PaO2 is normal.</p> Signup and view all the answers

<p>Decreased perfusion to the extremities can result in a falsely low SpO2 reading. This highlights the importance of assessing circulation and considering other factors beyond SpO2 readings in clinical decision-making.</p> Signup and view all the answers

<p>Oxygen is primarily transported by binding to hemoglobin within red blood cells, while carbon dioxide is transported through dissolved carbon dioxide, attachment to water as HCO3-, and binding to hemoglobin.</p> Signup and view all the answers

<p>Decreased ventilation leads to increased PaCO2 levels as carbon dioxide is retained in the body. This indicates poor alveolar ventilation and can signal respiratory distress.</p> Signup and view all the answers

<p>pH level measures blood acidity or alkalinity, influenced by carbon dioxide levels. Increased PaCO2 leads to a lower pH (more acidic), indicating potential respiratory acidosis.</p> Signup and view all the answers

<p>Carbon monoxide binds to hemoglobin, preventing oxygen from attaching, but the pulse oximeter cannot distinguish between oxygen and carbon monoxide, leading to a falsely high SpO2 reading.</p> Signup and view all the answers

<p>ABG provides a direct measurement of PaO2, which is unaffected by hemoglobin levels and reflects the actual oxygen dissolved in the blood, unlike SpO2 which only measures the percentage of hemoglobin saturated with oxygen.</p> Signup and view all the answers

<p>Hemoglobin within red blood cells binds to oxygen molecules, facilitating its transport throughout the body. Saturation of peripheral oxygen (SpO2) measured by pulse oximetry reflects the percentage of hemoglobin bound to oxygen.</p> Signup and view all the answers

<p>Patients with COPD often have chronic low oxygen levels and may adapt to lower SpO2 levels. Maintaining a slightly lower SpO2 range in these patients may prevent overstimulation of their respiratory system, which can be detrimental.</p> Signup and view all the answers

<p>The main purpose is to prevent pneumonia by keeping airways open and clear of mucus. Patients should use it ten times every hour while awake.</p> Signup and view all the answers

<p>Coughing and deep breathing technique does not require a device, whereas incentive spirometry uses a device to measure and encourage deep breaths.</p> Signup and view all the answers

<p>The huffing technique helps patients to cough by inhaling with a medium-sized breath and then making a sound like 'ha' to push the air out quickly with the mouth slightly open.</p> Signup and view all the answers

<p>The purpose is to help patients clear mucus from their airways, and it works by using a handheld device that creates vibrations to break up mucus, allowing the patient to cough and spit it out.</p> Signup and view all the answers

<p>It is important to create reminders because using an incentive spirometer can feel monotonous to patients, leading to a lack of adherence. An example of a helpful trigger is to use the incentive spirometer each time they view a commercial while watching television.</p> Signup and view all the answers

<p>The nurse should delegate the intervention, but monitor and document the frequency and volume achieved.</p> Signup and view all the answers

<p>It helps by keeping the airways open and clear of mucus, allowing for better oxygenation and reducing the risk of atelectasis and pneumonia.</p> Signup and view all the answers

<p>It helps to prevent the airways from collapsing and allows for more air to be exhaled, keeping the airways open and clear of mucus.</p> Signup and view all the answers

<p>It is important to expel mucus to clear the airways and prevent infection. Patients should avoid swallowing the mucus.</p> Signup and view all the answers

<p>Patients should perform coughing and deep breathing technique three to five times every hour while awake.</p> Signup and view all the answers

<p>Dyspnea is a subjective feeling of not getting enough air and is a sign of respiratory distress, which can cause anxiety and restlessness.</p> Signup and view all the answers

<p>SpO2 levels below 92% may indicate hypoxia, and levels below 88% may indicate severe hypoxia, requiring medical intervention.</p> Signup and view all the answers

<p>The tripod position allows for increased lung expansion, enhancing breathing and relieving dyspnea.</p> Signup and view all the answers

<p>Noisy breathing is an indication of respiratory conditions and may require further assessment with a stethoscope for adventitious sounds.</p> Signup and view all the answers

<p>Raising the head of the bed promotes effective chest expansion and diaphragmatic descent, maximizes inhalation, and decreases the work of breathing.</p> Signup and view all the answers

<p>Oxygen therapy is a medical emergency treatment that should be initiated promptly to prevent serious harm or death.</p> Signup and view all the answers

<p>Restlessness is an early sign of hypoxia, resulting in increased movement and the inability to stay still.</p> Signup and view all the answers

<p>Prompt reporting of changes in patient condition enables early detection and intervention, preventing respiratory failure.</p> Signup and view all the answers

<p>Tachypnea, an increased respiration rate, is an indication of respiratory distress and may be an early sign of hypoxia.</p> Signup and view all the answers

<p>The body regulates blood pH through a delicate balance maintained by the respiratory and renal systems. The respiratory system controls the elimination of carbon dioxide (CO2), a major acid in the blood. By increasing breathing rate and depth, the lungs expel more CO2, making the blood less acidic. Conversely, reducing respiration retains CO2, making the blood more acidic. The kidneys, on the other hand, regulate bicarbonate (HCO3-) levels, a key buffer. They can retain HCO3- to make the blood more alkaline and excrete it to make the blood less alkaline. This intricate interplay ensures that blood pH remains within the normal range of 7.35-7.45.</p> Signup and view all the answers

<p>Hypoxia is a general term for a reduced oxygen level in tissues, while hypoxemia is a specific type of hypoxia characterized by a decreased partial pressure of oxygen in the blood (PaO2). This means that while both indicate low oxygen levels, hypoxemia specifically refers to the reduction of oxygen in the blood as measured by an arterial blood gas (ABG) test.</p> Signup and view all the answers

<p>Hypercapnia, or elevated CO2 in the blood, can initially cause increased sedation and somnolence due to the CO2's direct depressant effect on the central nervous system. This effect may occur before significant changes in SpO2, as SpO2 primarily reflects the oxygen bound to hemoglobin, which can be maintained even with elevated CO2 levels. This creates a potentially dangerous situation as the patient may appear stable based on SpO2 alone, but their condition is actually deteriorating due to the CO2 buildup. It emphasizes the need for comprehensive assessment and monitoring beyond just SpO2 in patients with hypercapnia.</p> Signup and view all the answers

<p>Both SaO2 and SpO2 measure oxygen levels in the blood, but SaO2 is a more accurate measure of arterial oxygen saturation, calculated from blood gas analysis. It is not affected by poor perfusion, cool extremities, or carbon monoxide binding to hemoglobin, which can influence SpO2 readings. SpO2, measured by pulse oximetry, is a noninvasive estimate of oxygen saturation but can be less accurate in certain situations where factors like poor circulation or carbon monoxide poisoning can interfere.</p> Signup and view all the answers

<p>Hypoxia, or reduced tissue oxygenation, triggers physiological responses like increased heart rate and breathing rate as the body attempts to compensate for the oxygen deficiency. However, if hypoxia persists, the lack of oxygen in the blood results in a decreased saturation of hemoglobin with oxygen. Deoxygenated hemoglobin gives the blood a darker, bluish hue, which becomes visible in the skin and mucous membranes, leading to cyanosis. This bluish discoloration is a late sign of severe hypoxia, indicating a critical lack of oxygen reaching the tissues.</p> Signup and view all the answers

<p>Hypercapnia, or elevated CO2 in the blood, leads to respiratory acidosis due to the buildup of carbonic acid (H2CO3) in the blood. CO2 reacts with water to form carbonic acid, which releases hydrogen ions (H+), making the blood more acidic. This condition, if left unmanaged, can have serious consequences, leading to increased sedation, confusion, and even respiratory arrest. The patient's respiratory rate and depth may be compromised, and they may experience symptoms like tachycardia, dyspnea, and flushed skin.</p> Signup and view all the answers

<p>Bicarbonate (HCO3-) acts as a buffer in the blood, helping to neutralize excess acids and maintain a stable pH. The kidneys play a crucial role in regulating HCO3- levels. They can retain HCO3- to make the blood more alkaline or excrete it to make the blood less alkaline. This process ensures that the blood pH remains within the normal range, preventing conditions like acidosis or alkalosis.</p> Signup and view all the answers

<p>Untreated hypercapnia can lead to severe consequences, including respiratory failure, coma, and even death. Management typically involves addressing the underlying cause of hypercapnia. Noninvasive methods like BiPAP (bilevel positive airway pressure) can be used to assist ventilation and eliminate excess CO2. In more severe cases, intubation with mechanical ventilation may be necessary to maintain adequate oxygenation and CO2 removal.</p> Signup and view all the answers

<p>The body's response to hypoxia varies depending on the severity and duration of the oxygen deprivation. Early signs, often seen with mild hypoxia, include anxiety, confusion, restlessness, and increased respiratory rate. As hypoxia worsens, the patient's level of consciousness may decline, with vital signs becoming more unstable, including a faster heart rate and decreased pulse oximetry readings. Late signs, indicative of severe hypoxia, include cyanosis, a bluish discoloration of the skin and mucous membranes.</p> Signup and view all the answers

<p>While SpO2 provides valuable information about oxygen saturation, it is not sufficient to fully assess a patient with hypercapnia. Other vital signs, including respiratory rate, depth, and pattern, should be carefully monitored. Additionally, the patient's level of consciousness, mental status, and any signs of neurological compromise, such as confusion or sedation, should be assessed. A comprehensive approach ensures that the patient's condition is not misinterpreted and that appropriate interventions are implemented.</p> Signup and view all the answers

<p>Pursed-lip breathing helps patients control their breathing, improve ventilation, and maintain better oxygen saturation.</p> Signup and view all the answers

<p>A respiratory therapist can prescribe and adjust oxygen delivery systems, ensuring proper equipment setup and flow rates.</p> Signup and view all the answers

<p>Incentive spirometry encourages deep breathing to expand the lungs and prevent atelectasis.</p> Signup and view all the answers

<p>Bronchodilators relax smooth muscles in the airways, allowing for easier airflow and improved breathing.</p> Signup and view all the answers

<p>Pain medications can lead to respiratory depression, which may worsen the patient's breathing difficulties.</p> Signup and view all the answers

<p>Patients with weakened cough reflexes may require oral suctioning to clear secretions and prevent aspiration.</p> Signup and view all the answers

<p>Chest physiotherapy is indicated for patients who need assistance in mobilizing secretions for effective airway clearance.</p> Signup and view all the answers

<p>'Air hunger' refers to a severe feeling of dyspnea, and effective pain management can help decrease the work of breathing experienced by patients.</p> Signup and view all the answers

<p>Worsening dyspnea may be caused by secondary conditions such as pulmonary embolism or heart failure, necessitating a thorough assessment.</p> Signup and view all the answers

<p>Proper management of oxygen equipment ensures that patients receive the correct flow and type of oxygen therapy needed for their condition.</p> Signup and view all the answers

<p>Oxyhemoglobin is transported from the lungs to the peripheral tissues through the binding of oxygen to hemoglobin in red blood cells.</p> Signup and view all the answers

<p>A pulse oximeter measures oxygen saturation levels by shining light through a patient's nail bed or earlobe and measuring the absorption of light by oxyhemoglobin and deoxyhemoglobin.</p> Signup and view all the answers

<p>Incentive spirometry is used to help patients with COPD take slow, deep breaths to improve lung function and increase oxygenation.</p> Signup and view all the answers

<p>Cyanosis is a bluish discoloration of the skin and mucous membranes that occurs when there is inadequate oxygenation of the blood, resulting in increased levels of deoxyhemoglobin.</p> Signup and view all the answers

<p>The dual circulation system, comprising the pulmonary and systemic circuits, works together to deliver oxygen-rich blood from the lungs to the peripheral tissues.</p> Signup and view all the answers

<p>The respiratory system responds to changes in carbon dioxide levels by increasing or decreasing ventilation to maintain acid-base balance.</p> Signup and view all the answers

<p>Bronchial sounds can indicate the presence of respiratory diseases or conditions, such as bronchitis or COPD, and can help healthcare providers diagnose and monitor lung function.</p> Signup and view all the answers

<p>The heart's pumping mechanism, through the contraction and relaxation of the atria and ventricles, pumps oxygen-rich blood from the lungs to the peripheral tissues.</p> Signup and view all the answers

<p>The alveoli are the site of gas exchange, where oxygen from the inhaled air diffuses into the blood and carbon dioxide from the blood diffuses out into the exhaled air.</p> Signup and view all the answers

<p>Respiratory failure can lead to inadequate oxygenation, resulting in hypoxia, acid-base imbalance, and potentially life-threatening complications.</p> Signup and view all the answers