Ch36 oxygenation

JUDITH M. WILKINSON LESLIE S. TREASKAREN BARNETT MABLE H. SMITH

FUNDAMENTALS OFFUNDAMENTALS OFNURSINGNURSING

Copyright © 2016 F.A. Davis Company

Chapter 36: Chapter 36: OxygenationOxygenation


Oxygenation

Oxygen•Atomic number: 8•Atomic mass: 16


Pulmonary System

• Airways and lungs• Ventilation

– Movement of air into/out of the lungs

• Respiration– Exchange of

oxygen/carbon dioxide

– Alveolar capillary/capillary cell membrane


ClickerCheck

Which diagnostic test/exam would best measure a client’s level of hypoxemia?

a.Chest x-rayb.Pulse oximeter readingc.ABGd.Peak expiratory flow rate


ClickerCheck (cont’d)

Correct answer: C

The term “hypoxemia” means low blood oxygen level. Arterial blood gas sampling is the most direct way in which the level of oxygen in the blood can be measured.


Factors That Influence Pulmonary Function• Life span and development (e.g.,

respiratory distress syndrome, upper respiratory infections [URIs], adolescent smoking, cardiac insufficiency)

• Environment (e.g., stress, allergies)• Lifestyle (e.g., nutrition, exercise,

substance abuse)• Medications• Smoking


Factors That Influence Pulmonary Function (cont’d)

• Pulmonary system abnormalities (structure, airway inflammation/obstruction, alveolar-capillary membrane disorder, atelectasis)

• Pulmonary circulation abnormalities• Central nervous system abnormalities• Neuromuscular abnormalities


Assessing Oxygenation Status

Physical examination•Breathing pattern•Respiratory effort•Pulse oximetry•Using inspection, palpation, percussion, and auscultation


ClickerCheck

The term “Kussmaul” refers to a high-pitched, harsh, crowing inspiratory sound that occurs due to partial obstruction of the larynx.

a.Trueb.False



Correct answer: B

The term for this sound of respiratory distress is “stridor.”


Assessing Oxygenation Status

• Diagnostic testing• Arterial blood gases (ABGs)

– PO2, PCO2

• Peak flow monitoring


Interventions for Optimal Oxygenation• Use of a mechanical ventilator• Use of chest tube

drainage systems• Administering

respiratory medications


Interventions for Optimal Oxygenation (cont’d)

Promoting respiratory function•Immunizations/prevent URIs•Positioning: maximum lung excursion•Incentive spirometry•Aspiration precautions



• Mobilizing secretions– Deep breathing

and coughing– Hydration– Chest physiotherapy

• Oxygen therapy– Cannula– Mask– Transtracheal catheter



• Using artificial airways– Oropharyngeal– Nasopharyngeal– Endotracheal tubes– Tracheostomy tube

• Artificial airway patency – Suctioning


ClickerCheck

In caring for a client with a tracheostomy, the nurse would give priority to the nursing diagnosis of

a.Risk for ineffective airway clearanceb.Anxiety related to suctioningc.Social isolation related to altered body imaged.Impaired tissue integrity



Correct answer: A

While other diagnoses may be applicable, maintaining a patent airway by tending to excessive secretions is a priority.


Think Like a Nurse

Ms. Saunders (Meet Your Patients) has adequate blood oxygen levels based on a pulse oximeter reading of 98%. Can you conclude that organ and tissue oxygenation are adequate? Explain your thinking.

Ch36 oxygenation

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