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Oxygenation: Mosby Items and Derived Items © 2005 by Mosby, Inc

The document discusses factors that can affect oxygenation including physiological, developmental, lifestyle, and environmental factors. It also discusses assessing oxygenation through physical exams, diagnostic tests, and nursing diagnoses as well as planning, implementing, and evaluating care related to oxygenation.

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3amabelle arevalo
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56 views29 pages

Oxygenation: Mosby Items and Derived Items © 2005 by Mosby, Inc

The document discusses factors that can affect oxygenation including physiological, developmental, lifestyle, and environmental factors. It also discusses assessing oxygenation through physical exams, diagnostic tests, and nursing diagnoses as well as planning, implementing, and evaluating care related to oxygenation.

Uploaded by

3amabelle arevalo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Chapter 39

Oxygenation

Mosby items and derived items © 2005 by Mosby, Inc.


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

Mosby items and derived items © 2005 by Mosby, Inc.


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

Mosby items and derived items © 2005 by Mosby, Inc.


Factors Affecting Oxygenation
• Physiological factors: cardiac
– Conduction disturbances
– Impaired valvular function
– Myocardial hypoxia
– Cardiomyopathic conditions
– Peripheral tissue hypoxia

Mosby items and derived items © 2005 by Mosby, Inc.


Factors Affecting Oxygenation
(cont'd)
• Physiological factors: respiratory
– Hyperventilation
– Hypoventilation
– Hypoxia

Mosby items and derived items © 2005 by Mosby, Inc.


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

Mosby items and derived items © 2005 by Mosby, Inc.


Factors Affecting Oxygenation
(cont'd)
• Additional physiological factors
– Musculoskeletal abnormalities
– Trauma
– Neuromuscular diseases
– Central nervous system alterations
– Chronic disease

Mosby items and derived items © 2005 by Mosby, Inc.


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

Mosby items and derived items © 2005 by Mosby, Inc.


Alterations in Respiratory
Functioning
• Hyperventilation
• Hypoventilation
• Hypoxia

Mosby items and derived items © 2005 by Mosby, Inc.


Developmental Factors
• Infants and toddlers
• School-age children and adolescents
• Young and middle adults
• Older adults

Mosby items and derived items © 2005 by Mosby, Inc.


Lifestyle Factors
• Nutrition
• Exercise
• Smoking
• Substance abuse
• Stress

Mosby items and derived items © 2005 by Mosby, Inc.


Environmental Factors
• Residence location
• Occupation

Mosby items and derived items © 2005 by Mosby, Inc.


Nursing History
• Fatigue
• Dyspnea
• Cough
• Wheezing
• Pain
• Environmental or geographical
exposures

Mosby items and derived items © 2005 by Mosby, Inc.


Nursing History (cont'd)
• Respiratory infections
• Health risks
• Medications

Mosby items and derived items © 2005 by Mosby, Inc.


Assessment of Oxygenation
• Physical examination
– Inspection
– Palpation
– Percussion
– Auscultation

Mosby items and derived items © 2005 by Mosby, Inc.


Assessment of Oxygenation
(cont'd)
• Diagnostic tests: blood studies
– Complete blood count
– Cardiac enzymes
– Cardiac troponin I
– Serum electrolytes
– Cholesterol

Mosby items and derived items © 2005 by Mosby, Inc.


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

Mosby items and derived items © 2005 by Mosby, Inc.


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

Mosby items and derived items © 2005 by Mosby, Inc.


Assessment of Oxygenation
(cont'd)
• Diagnostic tests: ventilation studies
(cont'd)
– Thoracentesis
– Throat cultures
– Sputum specimens

Mosby items and derived items © 2005 by Mosby, Inc.


Nursing Diagnoses
• Ineffective airway clearance
• Ineffective breathing pattern
• Decreased cardiac output
• Impaired gas exchange
• Risk for infection
• Ineffective tissue perfusion
• Impaired spontaneous ventilation

Mosby items and derived items © 2005 by Mosby, Inc.


Planning
• Goals and outcomes
– Client’s lungs are clear on auscultation
– Client coughs productively
• Setting priorities
• Continuity of care

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation:
Health Promotion
• Body weight
• Diet
• Exercise
• Stress reduction
• Occupational safety
• Smoke-free
• Regular physical examinations

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation: Health
Promotion (cont'd)
• Vaccinations/immunizations
– Influenza
– Pneumonia

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation: Acute Care
• Dyspnea management
• Airway maintenance
– Mobilization of secretions
– Suctioning
– Artificial airways

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation: Acute Care
(cont'd)
• Maintenance and promotion of lung
expansion
– Positioning
– Incentive spirometry
– Chest tubes

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation: Acute Care
(cont'd)
• Maintenance and promotion of
oxygenation: oxygen therapy
– Safety precautions
– Oxygen supply
– Methods of oxygen delivery
– Home oxygen therapy

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation: Acute Care
(cont'd)

• Restoration of cardiopulmonary
functioning—CPR

Mosby items and derived items © 2005 by Mosby, Inc.


Implementation: Restorative Care
• Hydration
• Coughing techniques
• Respiratory muscle training
• Breathing exercises

Mosby items and derived items © 2005 by Mosby, Inc.


Evaluation
• Client care
• Client expectations

Mosby items and derived items © 2005 by Mosby, Inc.

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