Oxygenation and Respiratory Terminology

Oxygenation

• Lungs oxygenate the body and remove CO2
• Alveoli perform gas exchange
• Alveoli are the endpoint of the respiratory system, exchanging oxygen and carbon dioxide in the blood stream
• Oxygenation can be affected by illnesses and conditions that affect ventilation, perfusion, and gas exchange
• These alterations can cause hyperventilation, hypoventilation, and hypoxia.

Terminology

• Ventilation: the flow of air in and out of the alveoli. Oxygen enters, carbon dioxide exits.
• Hyperventilation: low CO2, increased breathing rate/depth, causes blood pH to raise, leading to alkalosis.
• Hypoventilation: high CO2, shallow/slow breathing, causes blood pH to decrease, leading to acidosis.

Hypoxia

• Lack of oxygen in body tissues
• Causes include: low RBC count, decreased diffusion, COPD, pneumonia, poor tissue perfusion, decreased ventilation, high altitudes, COPD, asthma, medications that reduce respiratory rate, and anemia
• Signs/symptoms are not explicitly listed but likely related to decreased oxygen supply to tissues.

COPD - Chronic Obstructive Pulmonary Disease

• Progressive lung disease
• Causes persistent air flow obstruction, diagnosed with PFT
• Patients hospitalized for exacerbation of COPD
• Modifiable risk factors include: diet (low sodium, high fiber, omega-3 fatty acids), exercise (30-60 minutes daily), and avoiding smoking.
• Non-modifiable risk factors: age, family history.
• Signs/symptoms: difficulty breathing, cyanosis, clubbing of fingers/toes, barrel chest, delayed capillary refill (>3 seconds), wheezing, rhonchi (rattling noise).

Recurring Infections

• Risk for recurrent infections can be associated with COPD
• Other conditions can progress to CHF, pulmonary hypertension, depression, and psychosocial impact.

Emphysema – Pink Puffer

• Barrel chest
• Pursed lip breathing
• Improves air exchange
• Strengthens lungs
• Cachexia (weakness/wasting) from chronic illness
• Pink skin
• Accessory muscle use
• Hypercapnia
• Dyspnea
• Tachypnea
• Crackles + wheezes
• Fatigue

Chronic Bronchitis – Blue Bloater

• Chronic productive cough
• Purulent sputum
• Cyanosis
• Obesity
• Dyspnea
• Tachypnea
• Crackles + wheezes
• Fatigue

Medical Diagnostic Testing

• Chest X-ray
• Arterial blood gas (ABG)
• Measure O2 and CO2 in the blood
• Medical treatment and long-term management for chronic conditions.
• Nebulizer treatments

Fluid and Electrolytes

• Osmosis: Water moves from higher concentrations to lower concentrations of solutes.
• Hypervolemia: Excess fluid, solutes are diluted
• Hypovolemia: Not enough fluid, solutes increase

Fluid and Electrolyte Causes

• Malnutrition
• Interstitial fluid shift
• SIADH
• Excess fluid or sodium intake

FVD - Hypovolemia & Dehydration

• Causes: excessive diaphoresis, vomiting, fever, frequent urination, lack of fluid intake, medications, diabetes, and pregnancy.
• Signs/symptoms: Changes in skin turgor, skin tenting, dry skin, sticky/dry mucous membranes, tachycardia, weak/diminished pulse, postural hypotension (drop in BP when standing quickly).

IV fluid tonicity

• How IV fluids change cells. Isotonic fluids have equal concentrations within and outside cells, so there is no fluid shift. Hypertonic have more concentration outside the cells so draw water out of cells. Hypotonic have less concentration outside the cells so water is drawn into cells.

Additional Notes and Questions

• There may be some overlap amongst some of the conditions and symptoms in the different sections.
• Specific causes of illness, conditions, and symptoms are not always explicitly stated or explored in depth.
• More information about the questions is not available in the provided material.