#1 Unit 5 Oxygenation and Perfusion 12.29.23 (1).pptx

Unit 5 Oxygenation & Perfusion Lynnette Lynnette Taylor Taylor MSN/Ed, MSN/Ed, RN RN Ventura Ventura College College School School of of Nursing Nursing Factors Essential to Normal Functioning of the Respiratory System Integrity of the airway system Properly functioning alveolar system Properly func...

Unit 5 Oxygenation & Perfusion Lynnette Lynnette Taylor Taylor MSN/Ed, MSN/Ed, RN RN Ventura Ventura College College School School of of Nursing Nursing Factors Essential to Normal Functioning of the Respiratory System Integrity of the airway system Properly functioning alveolar system Properly functioning CV and hematologic systems Upper Airway Compone nts Nose Pharynx Larynx Epiglottis Function: Warm, filter, humidify inspired Lower Airway Components Trachea Right and left mainstem bronchi Segmental bronchi Terminal bronchioles Functions: conduction of air, mucociliary clearance, production of pulmonary surfactant Anatomy of the Lungs Main organs of respiration Extend from the base of the diaphragm to the apex above the first rib Right: 3 Left: 2 The lungs are composed of elastic tissue (alveoli, surfactant, pleura). The Organs of the Respiratory Tract Pulmonary Ventilation Inspiration: the active phase of ventilation Expiration: the passive phase of ventilation Gas Exchange (Respiration) Refers to the intake of O2and release of CO2 Made possible by respiration and perfusion Occurs via diffusion (movement of O2 and CO2 between the air and blood) Factors Influencing Diffusion of Gases in the Lungs Change in surface area available Thickening of alveolar-capillary membrane Partial pressure Assessment of Gas Transfer ABGs Pulse Oximetry % Hgb saturated with O2 SpO2 (94- ABG Provide info on acid-base status Determines pH of the blood, or how acidic it is Provides a precise measurement of the oxygen and carbon dioxide levels in your body Determines how well your lungs Respiratory Assessment Subjecti ve Objectiv e Sputum Thoracentesi s Skin tests PFTs Diagnostic Studies Bronchoscop y Lung biopsy Exercise test (6 min walk) Radiology: CXR, CT, MRI, pulm. angiogram PET Nasal cannula Nasopharyng eal catheter Transtracheal catheter Simple mask Partial rebreather mask Nonrebreath er mask Venturi mask Tent Recall The Oxygen Delivery Systems Precautions with O2 No flames, smoking Check electrical Avoid synthetics Avoid oils (spontaneous ignition) Type of Artificial Airways Oropharyngeal airway Nasopharyngeal airway Type of Artificial Airways Endotrache al tube Tracheosto my tube LMA (laryngeal mask airway) Geriatric Specific Variations Structural changes Defense mechanis ms Respirator y control Cardiovascu lar System Vital for exchange of gases Cone shaped, muscular pump, divided into four hollow chambers Blood Flow Upper chambers, atria, receive blood from the veins (the SVC, IVC, L/R pulm. veins) Lower chambers, ventricles, force blood out of the heart through the arteries (the left and right pulmonary arteries and the aorta). Mechanical System CO = HR x SV Systole: Contraction of heart muscle Diastole: Relaxation of heart muscle Stroke volume (SV): Cardiac output (CO): Amount of blood ejected from the ventricle with each heart beat the amount of blood pumped by each ventricle in 1 minute, is calculated by multiplying SV times HR: Factors Affecting Cardiac Output Preload Volume of blood in ventricles at end of diastole Contractility Afterload Peripheral resistance against which left ventricle must pump Structures and Functions of CV System Vascular system (blood vessels) Arteries, arterioles Veins, venules Capillaries Regulation of CV system Autonomic nervous system Baroreceptors Chemoreceptors Structures and Functions of Cardiovascular System Blood pressure Systolic blood pressure (SBP) < 120 mm Hg Diastolic blood pressure (DBP) < 80 mm Hg BP = CO x SVR Level of health Factors Affecting Cardiopulmon ary Functioning and Oxygenation Development Medication Lifestyle Environmental Psychological health Gerontologic Considerations Risk for cardiovascular disease (CVD) increases with age CVD leading cause of death in adults > 65 CV changes result of aging, disease, environmental factors, and lifetime behaviors Age-Related Changes Increased collagen, decreased elastin Decreased response to stress Heart valves become thick and stiff Number of pacemaker cells decrease Decreased number and function of β-adrenergic receptors Age-Related Changes Blood vessels thicken and less elastic Increase in SBP and decrease or no change in DBP Incompetent venous valves Orthostatic hypotension Postprandial hypotension Assessment of CV/PV System Subjecti ve Data Objectiv e Data Biomarkers: Troponin, CK, Copeptin, Myoglobin BNP Lipid panel (triglycerides, cholesterol, phospholipids) Lipoproteins (HDLs, LDLs VDLs) Holter monitor ECG: stress test Radiology: CXR, Echocardiogram, CMRI, CTA, cardiac cath, coronary artery angiogram Diagnostic Studies CXR Find APE To Man Echocardiogr am 2-D echo References Lewis, S. L., Bucher, L., Heitkemper, M., Harding, M. M., Kwong, J., & Roberts, D. (2020). Medical surgical nursing: Assessment and management of clinical problems (11th ed.). St. Louis, MO: Mosby. Taylor, C., Lillis, C., Lynn, P., & LeMone, P. (2019). Fundamentals of nursing: The art and science of person-centered care (9th ed.). Philadelphia, PA: Wolters Kluwer.