Oxygenation
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Oxygenation

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Oxygenation Oxygenation Presentation Transcript

  • Chapter 39 Oxygenation
  • Cardiovascular Physiology
    • Structure and function
      • Myocardial pump
      • Myocardial blood flow
      • Coronary artery circulation
      • Systemic circulation
      • Blood flow regulation: cardiac output, preload, afterload, contractility
      • Conduction system
  • Respiratory Physiology
    • Structure and function (cont'd)
      • Breathing: inspiration, expiration
      • Lung volumes and capacities
      • Pulmonary circulation
      • Respiratory gas exchange: oxygen, carbon dioxide
      • Regulation of respiration
    View slide
  • Factors Affecting Oxygenation
    • Physiological factors: cardiac
      • Conduction disturbances
      • Impaired valvular function
      • Myocardial hypoxia
      • Cardiomyopathic conditions
      • Peripheral tissue hypoxia
    View slide
  • Factors Affecting Oxygenation (cont'd)
    • Physiological factors: respiratory
      • Hyperventilation
      • Hypoventilation
      • Hypoxia
  • Factors Affecting Oxygenation (cont'd)
    • Additional physiological factors
      • Decreased oxygen-carrying capacity
      • Decreased inspired oxygen concentration
      • Hypovolemia
      • Increased metabolic rate
      • Conditions affecting chest wall movement
  • Factors Affecting Oxygenation (cont'd)
    • Additional physiological factors
      • Musculoskeletal abnormalities
      • Trauma
      • Neuromuscular diseases
      • Central nervous system alterations
      • Chronic disease
  • Alterations in Cardiac Functioning
    • Conduction disturbances
      • – Atrial and ventricular dysrhythmias
    • Altered cardiac output
      • – Heart failure
    • Impaired valvular function
    • Myocardial ischemia
      • – Angina, MI, acute coronary syndrome
  • Alterations in Respiratory Functioning
    • Hyperventilation
    • Hypoventilation
    • Hypoxia
  • Developmental Factors
    • Infants and toddlers
    • School-age children and adolescents
    • Young and middle adults
    • Older adults
  • Lifestyle Factors
    • Nutrition
    • Exercise
    • Smoking
    • Substance abuse
    • Stress
  • Environmental Factors
    • Residence location
    • Occupation
  • Nursing History
    • Fatigue
    • Dyspnea
    • Cough
    • Wheezing
    • Pain
    • Environmental or geographical exposures
  • Nursing History (cont'd)
    • Respiratory infections
    • Health risks
    • Medications
  • Assessment of Oxygenation
    • Physical examination
      • Inspection
      • Palpation
      • Percussion
      • Auscultation
  • Assessment of Oxygenation (cont'd)
    • Diagnostic tests: blood studies
      • Complete blood count
      • Cardiac enzymes
      • Cardiac troponin I
      • Serum electrolytes
      • Cholesterol
  • Assessment of Oxygenation (cont'd)
    • Diagnostic tests: cardiac function
      • Electrocardiogram (ECG)
      • Holter monitor
      • Exercise stress test
      • Thallium stress test
      • Electrophysiological study (EPS)
      • Echocardiography
      • Scintigraphy
      • Cardiac catheterization
  • Assessment of Oxygenation (cont'd)
    • Diagnostic tests: ventilation studies
      • Pulmonary function
      • Peak expiratory flow rate (PEFR)
      • Arterial blood gases
      • Oximetry
      • Chest x-ray
      • Bronchoscopy
      • Lung scan
  • Assessment of Oxygenation (cont'd)
    • Diagnostic tests: ventilation studies (cont'd)
      • Thoracentesis
      • Throat cultures
      • Sputum specimens
  • Nursing Diagnoses
    • Ineffective airway clearance
    • Ineffective breathing pattern
    • Decreased cardiac output
    • Impaired gas exchange
    • Risk for infection
    • Ineffective tissue perfusion
    • Impaired spontaneous ventilation
  • Planning
    • Goals and outcomes
      • Client’s lungs are clear on auscultation
      • Client coughs productively
    • Setting priorities
    • Continuity of care
  • Implementation: Health Promotion
    • Body weight
    • Diet
    • Exercise
    • Stress reduction
    • Occupational safety
    • Smoke-free
    • Regular physical examinations
  • Implementation: Health Promotion (cont'd)
    • Vaccinations/immunizations
      • Influenza
      • Pneumonia
  • Implementation: Acute Care
    • Dyspnea management
    • Airway maintenance
      • Mobilization of secretions
      • Suctioning
      • Artificial airways
  • Implementation: Acute Care (cont'd)
    • Maintenance and promotion of lung expansion
      • Positioning
      • Incentive spirometry
      • Chest tubes
  • Implementation: Acute Care (cont'd)
    • Maintenance and promotion of oxygenation: oxygen therapy
      • Safety precautions
      • Oxygen supply
      • Methods of oxygen delivery
      • Home oxygen therapy
  • Implementation: Acute Care (cont'd)
    • Restoration of cardiopulmonary functioning — CPR
  • Implementation: Restorative Care
    • Hydration
    • Coughing techniques
    • Respiratory muscle training
    • Breathing exercises
  • Evaluation
    • Client care
    • Client expectations