1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 21 Oxygenation

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Oxygen: measures approximately 21% in the Earth’s atmosphere  Each cell of the human body uses oxygen to metabolize nutrients and produce energy  Without oxygen, cell death occurs rapidly

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Is the following statement true or false? Expiration creates more chest space, causing the pressure within the lungs to fall below that in the atmosphere.

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins False. Inhalation creates more chest space, causing the pressure within the lungs to fall below that in the atmosphere.

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Inspiration and expiration  Ventilation: movement of air in and out of lungs; facilitates respiration  Respiration: exchange of oxygen and carbon dioxide

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  External and internal respiration  External respiration takes place at most distal point in airway: between the alveolar-capillary membranes  Internal respiration occurs at the cellular level between hemoglobin and body cells

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Physical assessment  Monitoring the client’s respiratory rate  Observing breathing pattern and effort  Checking chest symmetry  Auscultating lung sounds

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Arterial blood gases measure:  Partial pressure of oxygen dissolved in plasma  Percentage of hemoglobin saturated with oxygen  The pH of blood

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

10.  Pulse oximetry  Composed of a sensor and a microprocessor  Noninvasive, transcutaneous technique for periodically or continuously monitoring the oxygen saturation of blood

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Which of the following is used for monitoring the oxygen saturation of blood? a. Arterial blood gases b. Pulse oximetry c. Incentive spirometry d. Oxygen analyzer

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins b. Pulse oximetry Pulse oximetry is a technique for periodically or continuously monitoring the oxygen saturation of blood. Arterial blood gases monitor the pH of blood. Incentive spirometry is a technique for deep breathing using a calibrated device. Oxygen analyzer is a device that measures the percentage of delivered oxygen to the client.

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Positioning: Fowler’s position  Breathing techniques  Deep breathing o Incentive spirometry  Pursed-lip breathing  Diaphragmatic breathing  Nasal strips

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

15.  Oxygen sources  Wall outlet  Portable tanks  Liquid oxygen unit  Oxygen concentrator  Equipment used in oxygen administration

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Equipment used in oxygen administration  Flowmeter  Oxygen analyzer  Humidifier  Common delivery devices  Nasal cannula

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Common delivery devices (cont’d)  Masks o Simple mask o Partial rebreather mask o Non-rebreather mask o Venturi mask

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Common delivery devices (cont’d)  Face tent  Tracheostomy collar  T-piece  Additional delivery devices  Nasal catheter

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins (Refer to Table 21-4 in the textbook.)

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Additional delivery devices (cont’d)  Oxygen tent and CPAP mask  Transtracheal oxygen  Oxygen hazards  Fire potential  Oxygen toxicity

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

22.  Which of the following is a common delivery device for oxygen? a. Flowmeter b. Nasal cannula c. Oxygen analyzer d. Humidifier

23. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins b. Nasal cannula Nasal cannula is a common delivery device. Flowmeter, oxygen analyzer, and humidifier are equipment used in oxygen administration.

24. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Water-seal chest tube drainage  A technique for evacuating air or blood from the pleural cavity  Hyperbaric oxygen therapy  Delivery of 100% oxygen at 3 times the normal atmospheric pressure within an airtight chamber

25. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Nursing diagnoses: hypoxemia or hypoxia  Ineffective breathing pattern  Impaired gas exchange  Anxiety  Risk for injury (related to oxygen hazards)

26. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins (Refer to Nursing Care Plan 21-1in the textbook.)

27. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Reduced gas exchange and efficiency in ventilation; major age-related changes occur in the respiratory system  Respiratory muscles become weaker and the chest wall becomes stiffer as a result of calcification of the intercostal cartilage

28. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins  Diminished cough and gag reflexes, increased use of accessory muscles for breathing, increased mouth breathing, snoring  Inactive, debilitated, or chronically ill clients or smokers are at a higher risk for respiratory infections and compromised respiratory function