Podcast
Questions and Answers
Which statement best describes the relationship indicated by the oxyhemoglobin dissociation curve?
Which statement best describes the relationship indicated by the oxyhemoglobin dissociation curve?
- The relationship between oxygen saturation of hemoglobin and partial pressure of arterial oxygen. (correct)
- The correlation between a patient's age and their hemoglobin levels.
- The relationship between carbon dioxide levels and blood pH.
- The amount of oxygen dissolved in the plasma, irrespective of hemoglobin.
What physiological response occurs when the partial pressure of oxygen (Po2) decreases?
What physiological response occurs when the partial pressure of oxygen (Po2) decreases?
- Oxygen delivery to tissues remains constant.
- Hemoglobin releases oxygen more readily to meet tissue demands. (correct)
- Hemoglobin retains oxygen more strongly, decreasing oxygen delivery to tissues.
- The saturation rate of hemoglobin goes up.
In a situation where tissues are inactive and have minimal oxygen demand, how does hemoglobin behave according to the basic principles of oxygen regulation?
In a situation where tissues are inactive and have minimal oxygen demand, how does hemoglobin behave according to the basic principles of oxygen regulation?
- Hemoglobin releases all of its bound oxygen.
- Hemoglobin's behavior is not affected by tissue oxygen demand.
- Hemoglobin saturation increases because less oxygen is being extracted by tissues. (correct)
- Hemoglobin saturation decreases to provide more oxygen to the tissues.
Under normal physiological conditions, what percentage of oxygen is typically released from hemoglobin to the tissues, and what is the significance of the remaining oxygen?
Under normal physiological conditions, what percentage of oxygen is typically released from hemoglobin to the tissues, and what is the significance of the remaining oxygen?
How would a nurse interpret a patient's arterial blood gas results indicating acidosis (low pH) in relation to the oxyhemoglobin dissociation curve?
How would a nurse interpret a patient's arterial blood gas results indicating acidosis (low pH) in relation to the oxyhemoglobin dissociation curve?
A patient with a high temperature (febrile) is likely to experience what shift in the oxyhemoglobin dissociation curve, and what is the physiological consequence?
A patient with a high temperature (febrile) is likely to experience what shift in the oxyhemoglobin dissociation curve, and what is the physiological consequence?
What effect does decreased 2,3-DPG have on the oxyhemoglobin dissociation curve and oxygen affinity?
What effect does decreased 2,3-DPG have on the oxyhemoglobin dissociation curve and oxygen affinity?
Even with a pulse oximeter reading of 95% or higher, which factors could still indicate potential issues with a patient's oxygenation status?
Even with a pulse oximeter reading of 95% or higher, which factors could still indicate potential issues with a patient's oxygenation status?
A patient is slightly tachycardic and tachypneic, and appears restless. What should the nurse prioritize in the initial assessment?
A patient is slightly tachycardic and tachypneic, and appears restless. What should the nurse prioritize in the initial assessment?
Which of the following conditions would cause the oxyhemoglobin dissociation curve to shift to the left?
Which of the following conditions would cause the oxyhemoglobin dissociation curve to shift to the left?
Flashcards
Oxyhemoglobin
Oxyhemoglobin
The oxygen bound hemoglobin molecule (HbO2).
Oxyhemoglobin Dissociation Curve
Oxyhemoglobin Dissociation Curve
Indicates the relationship between oxygen saturation of hemoglobin and the partial pressure of arterial oxygen (PaO2).
Effect of Increased Po2
Effect of Increased Po2
When Po2 increases, hemoglobin's affinity for oxygen increases, and it stores more oxygen.
Effect of Decreased Po2
Effect of Decreased Po2
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Oxygen Release at Rest
Oxygen Release at Rest
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Shift to the right
Shift to the right
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What causes a shift to the right?
What causes a shift to the right?
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Shift to the left
Shift to the left
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What causes a shift to the left?
What causes a shift to the left?
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Pulse Ox Limitations
Pulse Ox Limitations
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Study Notes
- The oxyhemoglobin dissociation curve is being decoded
Learning Objectives
- Identify shifts in the oxyhemoglobin disassociation curve
- Implement nursing care for patients with shifts in the oxyhemoglobin disassociation curve
- Identify patient manifestations impacting SpO2 monitoring and readings
- Compare patient presentations for curve shifts to the left or right
Oxyhemoglobin Dissociation Curve
- Oxyhemoglobin is the oxygen bound hemoglobin molecule, HbO2
- The dissociation curve indicates the relationship between oxygen saturation of hemoglobin and partial pressure of arterial oxygen, paO2
- The curves importance is RBCs flowing to body tissues detach oxygen from hemoglobin, which diffuses from capillaries into tissue
- Adequate oxygen movement from lungs to tissues/cells enables survival
Basic Principals
- Hemoglobin stores oxygen when Po2 increases
- The saturation goes up when hemoglobin stores oxygen
- Hemoglobin releases oxygen to tissues when Po2 decreases
- The saturation goes down when hemoglobin releases oxygen
- A mechanism is provided for auto regulation of oxygen delivery
- Inactive tissues have little demand for oxygen
- Active tissues use oxygen at an accelerated rate
Key Facts
- Normal tissue Pao2 is 40mm Hg and the sat is 75 in a normal, homeostatic situation
- 25% of oxygen comes off the Hgb molecule
- A reserve is maintained to keep oxygen on standby, for emergencies
- You have a reserve in your body so that supply can meet demand
- Hemoglobin's affinity for oxygen can change, in order to increase or decrease supply to the tissue
Changing Hemoglobin's Affinity for Oxygen
- Acidosis (low pH) can change hemoglobin's affinity for oxygen
- Increased 2,3-DPG (increased Co2) can change hemoglobin's affinity for oxygen
- Increased temperature as seen in febrile patients can shift the reading to the right
- Hgb gives O2 to the tissues more easily
- Alkalosis (high pH) can change hemoglobin's affinity for oxygen
- Decreased 2,3-DPG (decreased Co2) can change hemoglobin's affinity for oxygen
- Hypothermia in patients with a low temperature can cause shifts to the left
- Hgb holds onto O2
Pulse Oximeter Information
- Generally, a pulse ox of 95% or higher is clinically acceptable
- A pulse ox of 90% or lower is a red flag
- On the curve a pulse ox of 90% = PaO2 of 60mm Hg = Hypoxia
- The pulse ox does not show:
- Hemoglobin level and whether or not it is functional
- carboxyhemoglobin/methemoglobin
- PaCo2
- Ventilation status
- Patient and technical information
Signs and Symptoms
- The patient may be slightly tachycardia
- The patient may be slightly tachypnea
- The patient may be alert and oriented, but maybe restless
- The patient is normotensive
- The patient is febrile
- The patient's pulse ox is dropping
- Consider whether ABGs are needed
- Consider the current and trended H&H
- Consider the presence of an existing or new infection
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