Oxygenation Midterms Transes PDF

OXYGENATION MIDTERMS TRANSES UNDERSTANDING THE CONCEPT OF OXYGENATION Internal respiration ○ - Internal respiration: respiratory system + cardiovascular system; cellular...

OXYGENATION MIDTERMS TRANSES UNDERSTANDING THE CONCEPT OF OXYGENATION Internal respiration ○ - Internal respiration: respiratory system + cardiovascular system; cellular respiration FACTORS AFFECTING OXYGENATION - External respiration: respiratory system PHYSIOLOGICAL ○ As person ages the lumen of blood - ATP - gasoline of the cells that are produced to vessel narrows and hardens perform metabolic function DEVELOPMENTAL FACTORS LIFESTYLE ENVIRONMENTAL FACTORS IMPORTANCE ○ Place where you live; filled with fumes, Cellular Respiration polluted ○ Part of the internal respiration ○ We need 10-12 ATPs in order for the PHYSIOLOGIC FACTORS lungs to function Decreased oxygen carrying capacity ○ Aerobic metabolism: ○ Anemia 32 - 36 ATPs are produced ○ Sickle cell disease ○ Anaerobic metabolism: Decreased inspired oxygen concentration ATP can be produced without (obstruction in airway tract hypovolemia, oxygen increased metabolic rate) 2 ATPs are produced ○ Hypothyroidism ○ ATPs are gasoline needed by the cell in Hyperventilation order to produce metabolic processes ○ Intense emotion ○ Exhaustion Brain Function Hypoventilation ○ Cerebral hypoxia Hypoxia Oxygen depletion Condition affecting chest wall movement Sign: decreased LOC ○ Flail chest: restriction or deviation of ○ Direct body systems: Respiratory and chest wall movement; instead of Cardiovascular System expanding, flail chest goes down ○ Oxygen depletion = depletion of (paradoxical chest movement) production of ATP ○ Trauma - Flail chest; Paradoxical chest movement Heart health ○ Main supplier of oxygen LIFESTYLE FACTORS ○ Mainly responsible for delivery of Nutrition oxygenated blood to the cells, which is ○ Green Leafy Vegetables = provider of responsible for cellular respiration high oxygen Exercise Immune System Efficiency Smoking ○ Oxygenated blood brings healthy WBC Substance abuse Stress Tissue Repair and Healing ○ Cardinal Signs of inflammatory ENVIRONMENTAL FACTORS Responses: Residence Dolor = pain Work-place Tumor = swelling Usual location Rubor = redness Calor = heat STATISTICS (YEAR 2021) ○ Proper oxygenation innervates tissue repair Metabolic Process ○ Anaerobic metabolism = produces toxic byproducts High acidity - killer of cell; cells cannot survive OXYGENATION PROCESS - When the lungs expand it creates a vacuum so environmental O2 can be suctioned in (negative pressure) - Machine Provides positive pressure mechanism 1. Respiratory failure - 44.18% total 2. Pneumonia - 15.92% total External respiration 3. Lung cancer - 11.20% total ○ The thoracic expands - lifted anteriorly 4. Pulmonary diseases - 8.63%% total ○ Phrenic nerve; damaged in whiplash 5. Pulmonary embolism - 5.50% total injury 6. Lung edema - 3.93% total C1-C4 7. Respiratory infections - 2.10% total Nerve that aids breathing Erica, Pauline, Lucky ☤ RN 2025  2 Coronary Heart Disease caused 375,476 deaths Sinus Bradycardia in 2021 Heart Disease is the leading cause of death for men, women, and people of most racial and ethnic groups One person dies every 33 seconds from cardiovascular disease In 2022, 702,880 people died from heart P waves PR QRS Rhythm Rate disease. That’s the equivalent of 1 in every 5 Interval Complex deaths CARDIOVASCULAR CONDITIONS HIDHS Normal: ALTERATION IN CARDIAC FUNCTION ○ Athletes Illness and conditions affecting cardiac strength ○ During sleep of contraction, blood flow through the heart or to the heart muscles, and decreased peripheral Vagal stimulation circulation cause alterations in cardiac ○ When vagal nerve is stimulated, it functioning activates the parasympathetic nervous ○ Cardiac strength system and it regulates the heart rate Left ventricular hypertrophy through relaxation ○ Blood flow Atherosclerosis Medications: Arteriosclerosis ○ Digitalis Older adults experience alterations in cardiac ○ Beta-blockers functions as a result of calcification of the ○ Calcium channel blockers conduction pathways, thicker and shifter heart valves caused by lipid accumulation and fibrosis Disease Conditions and decreases in the number of pacemaker in ○ M.I cells in the S.A node ○ Myxedema ○ SA node -> AV node -> Purkinje fibers ○ Increased ICP Treatment high mortality rates in post-menopausal females due to ○ Not required unless symptomatic loss of hormones ○ Anticholinergic ○ Pacemaker as needed fish tongue - droop valve resembling a fish tongue; doesn't bounce back ; causes mitral valve regurgitation / SINUS TACHYCARDIA prolapse; its original position DISTURBANCES IN THE CONDUCTION Cardiac Rhythms Sinus Rhythms Atrial Rhythms Ventricular Rhythms P waves PR QRS Rhythm Rate AV Blocks Interval Complex SINUS RHYTHMS Fever Shock Pain Anxiety Heart failure Has P waves Hyper-metabolic states Has QRS complex Anemia Has T waves ○ Cells signals the heart to deliver more oxygenated blood Normal sinus rhythm Treatment: remove underlying cause PREMATURE ATRIAL CONTRACTIONS (PACs) P waves PR QRS Rhythm Rate Interval Complex P waves PR QRS Rhythm Rate Interval Complex Caffeine jErica, Pauline, Lucky ☤ RN 2025  3 Nicotine Heart Failure Epidemiology (MI) MI MI’s are the leading cause of death in the United Hyper-metabolic states States, affecting one in five men and one in six Treatment: not usually necessary women ○ With the absence of comorbidity 450,000 people in the US die from coronary disease each year ATRIAL FLUTTER (sawtooth pattern) CHEST PAIN MANAGEMENT P waves PR QRS Rhythm Rate Interval Complex RHD Thyrotoxicosis Heart failure Myocardial Ischemia 24 HOUR Halter - 2 lead wire Treatment: Stable Pleuritic / Lung pain: ○ Digoxin (Digitalis Therapy) - instruct the client to do deep breathing ○ Calcium channel blockers - pain when exhaling due to pleuritic rub ○ Beta-blockers ○ K-blockers Cardiac pain: - Administration of 3 doses of nitroglycerin; pain Unstable persists. ○ CARDIOVERSION - Pain persist more than 20 minutes Anticoagulation ATRIAL FIBRILLATION P waves PR QRS Rhythm Rate Interval Complex Irregularly irregular Etiology In atrial flutter - same pattern; a-fib - different patterns Non-Modifiable Risk Factors Age ○ More than 40 years MYOCARDIAL INFARCTION (MI) Sex A disease condition which is caused by reduced Family History blood flow in a coronary artery due to ○ MI can be inherited from parents to atherosclerosis and occlusion of an artery by an children embolus or thrombus Gender ○ MI is 3 times more in men than in women Modifiable Risk Factors High Blood Pressure High Lipids Level Hypertension Smoking Physical inactivity Obesity Diabetes mellitus Stress jErica, Pauline, Lucky ☤ RN 2025  4 That damage increases the risk of plque buildup in coronary arteries or can even cause a rupture of Plaque M.I “The way you handle stress also matters. If you respond to it in unhealthy ways – such as smoking, overeating or not exercising that makes matters worse” HIGH BLOOD CHOLESTEROL LEVE Press PATHOPHYSIOLOGY HDL are bigger in molecular size and easy to metabolize firstLDL can attach to the tunica ➔ Cholesterol deposition within the wall of the intima main artery When giving antilipemic drugs (-statins) liver ➔ This deposited profiling must be monitored: Liver is involved in fat metabolism- CLINICAL MANIFESTATIONS Pain HYPERTENSION ○ Chest pain due to a lack of blood and High blood pressure oxygen supply of the heart muscle Our arteries are designed to pump blood at a ○ Characteristics: severe, immobilizing, certain pressure. If that pressure is exceeded, chest pain the walls of the arteries will be damage ○ Usually described as heaviness, Injury to endothelial lining pressure, tightness, burning Narrow and thick arterial walls …. ○ Location: Substernal, Retrosternal or Epigastric SMOKING ○ Radiation: It may radiate to neck, jaw, Smoking can damage the walls of your arteries arm, or back (toxic substances in cigarette) ○ Duration: Lasts for 20 minutes or more Arteriosclerosis narrowed and thickened arterial walls Cardiovascular Risk of M.I ○ Initially the BP and pulse may be elevated. Later, BP will drop due to PHYSICAL INACTIVITY decrease cardiac output Improper lipid metabolism ○ Palpitation LDL level increase ○ Jugular Veins may become distended Starts accumulating in blood vessels and have obvious pulsations. Risk of M.I Respiratory OBESITY ○ Respiratory symptoms occur when the More lipids are produces damaged heart muscle limites the LDL level increases pumping actions of the left ventricle, Atherosclerosis causing acute left heart failure and Risk of M.I consequent lung congestion shortness of breath DIABETES MELLITUS Dyspnea / tachypnea diabetes increases the risk of MI Crackles Pulmonary edema STRESS Gastrointestinal Release stress hormones like adrenaline, ○ Nausea noradrenaline, and cortisol ○ Increase in heart rate, and elevated blood ○ Vomiting pressure ○ It’s causing damage over time to all your blood ○ Stimulation of vomiting center by severe vessel pain cause nausea and vomiting jErica, Pauline, Lucky ☤ RN 2025  5 FEVER ○ It is due to inflammatory process caused by Myocardial cell death. Integumentary system (Skin) Cool clammy skin Diaphoresis Pallor, Cyanosis Coolness of extremities ○ In response to pain and the blood flow abnormalities that result from dysfunction of the heart muscle ○ SYMPATHETIC NERVOUS SYSTEM STIMULATED ○ Increased catecholamine releases (adrenal medulla) ○ Diaphoresis (profuse sweating) ○ Cold & clammy skin (cold sweat) Genitourinary ○ Myocardial damage ○ Failure of the pump action of the heart, resulting in reduced cardiac output ○ Hypoperfusion to the kidney leads to decreased renal perfusion pressure which is required to maintain glomerular filtration rate in the kidney ○ ○ decrease GFR leads to decrease urinary output ○ Urine output (oliguria) Neurogenic ○ Due to inadequate blood flow to the brain Light-headedness headache Visual Disturbance Altered speech Altered motor functions Altered level of consciousness Psychosocial ○ Fear feeling ○ Pt. May deny that anything is wrong ASSESSMENT / DIAGNOSTIC FINDINGS It is generally based on presenting symptoms, ECG and laboratory test results. ○ Patient history-it includes Description of presenting symptoms ○ electrocardiogram provides information that assists in diagnosing acute mI ○ The classic ECG changes are: ST segment elevation ST depression T wave inversion Abnormal Q wave SERUM CARDIAC MARKERS CK-MB (Enzyme) Troponin E-T (Protein) cardiac dying enzymes are proteins that are released into the blood by dying heart muscles jErica, Pauline, Lucky ☤ RN 2025