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Janna Wickham RN MSN Lake Sumter Community College Nursing Foundation January 2013

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Learning Objectives

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Safe, Effective Care Environment Describe physiological processes affecting the client's ventilation, perfusion, and exchange of respiratory gases Assess the clients oxygenation status

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Health Promotion and Maintenance Develop nursing interventions that promote oxygenation Describe the impact of a client's level of health, age, lifestyle, and environment on tissue oxygenation

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Physiological Integrity Interpret diagnostic testing related to oxygenation, breathing, circulation, and gas exchange

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Systems Involved in Oxygenation Pulmonary Respiration Circulatory Perfusion Musculoskeletal Ventilation Neurological Ventilation

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Pulmonary Review Airway- Upper nasal passages mouth pharynx larynx trachea bronchi bronchioles

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Lungs-Lower- considered sterile Right- 3 lobes Left- 2 lobes Mediastinum- separates right from left Alveoli Alveoli-capillary membrane Gas Exchange Surfactant Pleura Pleural Space

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Gas Exchange

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Functions of Pulmonary System Ventilation Respiration Oxygenation Hypoxemia (blood) Perfusion Hypoxia

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Pulmonary Ventilation Inhalation Diaphragm contracts Exhalation Diaphragm Hyperventilation Hypoventilation

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Lung Compliance Conditions that reduce lung compliance Edema Scar tissue Loss of surfactant Lung elasticity Loss of elasticity results in lungs that inflate but air is trapped Airway resistance Small changes can cause increased airway resistance

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Respiration External Respiration Alveolar-Capillary Membrane Diffusion Conditions that slow or reduce gas exchange Internal Respiration

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How is Breathing Controlled Respiratory Center Brainstem Feedback system Chemoreceptors in the medulla, aorta, and carotid arteries Blood pH, O 2 levels, and CO 2 levels Lung receptors provide feedback

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Cardiovascular Deoxygenated blood flows into the right atrium Pulmonary circulation Alveolar-capillary membrane external gas exchange occurs Oxygenated blood flows from the lungs to the left side of the heart of out into the arterial circulation

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Blood Flow Song

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Heart Sinoatrial Node 60-100 Atrio-ventricular Node 40-60 Ventricular