Oxygenation Chapter 50

Respiratory Regulation Chemical Receptors “Respiratory Center”

Factors Affecting Respiratory Function Age Environment Lifestyle Health status Medications Stress

Conditions Affecting Airway Obstruction Upper airway obstruction Lower airway obstruction Completely obstructed airway - extreme inspiratory effort with no chest movement

Breathing Patterns Affecting Movement of Air Eupnea Tachypnea Bradypnea Apnea Hypoventilation Hyperventilation Kussmaul’s breathing Cheyne-Stokes respirations

Breathing Patterns Affecting Movement of Air (cont’d) Orthopnea Dyspnea

Conditions Affecting Diffusion Hypoxemia Signs and symptoms Chronic hypoxemia

Conditions Affecting Transport Conditions that decrease cardiac output Congestive heart failure Hypovolemia

Assessing Nursing history Physical examination Diagnostic studies

Nursing Diagnoses Ineffective Airway Clearance Ineffective Breathing Pattern Impaired Gas Exchange Activity Intolerance

Planning Maintain a patent airway Improve comfort and ease of breathing Maintain or improve pulmonary ventilation and oxygenation Improve ability to participate in physical activities

Implementing: Promoting Oxygenation Position Frequent position changes Deep breathing and coughing Incentive spirometer Ambulation Implement comfort measures

Implementing Hydration Medications Bronchodilators Anti-inflammatory Expectorants Cough suppressants

Implementing Percussion, vibration, postural drainage (PVD)

Implementing: Oxygen Therapy Check vital signs and oxygen saturation level Ordered for clients with hypoxemia, anemia, blood loss Primary care provider specifies concentration, method of delivery, liter flow per minute; may call for titration to achieve therapeutic level

Evaluation How do we know our interventions are helping? Collect data to evaluate effectiveness of interventions

Practice Mrs. Jones scenario