Oxygenation and Perfusion

Learning Outcomes

• Describe respiratory and cardiovascular anatomy and physiology.

• Identify factors affecting respiratory and cardiovascular function.

• Perform focused assessment of cardiopulmonary system.

• Describe nursing diagnoses and strategies for promoting adequate oxygenation.

Factors Affecting Cardiopulmonary Functioning

• Developmental considerations affect infants, toddlers, and older adults.

• Health conditions like kidney or heart disease can impact respiration.

• Medications and lifestyle choices influence cardiopulmonary function.

• Environmental factors and psychological health considerations play a role.

Nursing Process - Focused Assessment

• Includes evaluation of cough, sputum, pain, dyspnea, fever, and fatigue.

• Assessment covers usual respiration patterns, medications, health history, lifestyle, and environment.

Physical Examination

• Involves inspection, palpation, percussion, and auscultation.

• Assess level of consciousness, chest abnormalities, lung and heart sounds, and other physical signs.

Diagnostic Tests

• Tests like arterial blood gas analysis, ECG, echocardiography, and radiography are used.

• Other tests include cardiac catheterization, stress testing, Holter monitor, and pulmonary function studies.

Nursing Diagnosis

• Common diagnoses include ineffective airway clearance, impaired gas exchange, anxiety, and fatigue.

• Examples of defining characteristics for each diagnosis are provided.

Outcome Identification and Planning

• Goals include improved gas exchange and cardiopulmonary functioning.

• Strategies aim to maintain optimal activity levels and preserve pulmonary function.

Implementing Nursing Measures

• Recommendations include adopting a healthy lifestyle, regular exercise, and monitoring health indicators.

• Promoting optimal function involves maintaining good nutrition, a pollution-free environment, and vaccinations.

Promoting Optimal Function

• Suggestions include having a pollution-free environment and getting vaccinated against influenza and pneumococcal disease.

Implementing - Maintaining Good Nutrition

• Encourages adequate intake of proteins, vitamins, and minerals.

• Provides dietary recommendations for patients with cardiovascular diseases.

• Emphasizes oral hygiene, rest periods before meals, and meal timing after treatments.

Implementing - Promoting Comfort

• Recommends maintaining adequate fluid intake and proper positioning for breathing.

• Highlights the importance of humidified air in certain circumstances.

Promoting Proper Breathing

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• Deep breathing exercises

  • Patient inhales through the nose, counts to three, then exhales slowly against pursed lips.

• Pursed-lip breathing

  • Inhale through the nose, exhale slowly against pursed lips while tightening abdominal muscles.

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• Diaphragmatic Breathing

  • Patient breathes in slowly through the nose, lets abdomen protrude, then exhales through pursed lips while contracting abdominal muscles.

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• Using incentive spirometry

  • Provides visual reinforcement for deep breathing.

  • Assists the patient to breathe slowly and deeply.

Coughing and Medications

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• Control coughing

  • Cover mouth and nose when coughing or sneezing.

  • Wash hands after coughing or sneezing.

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• Types of coughing

  • Voluntary and involuntary coughing.

  • Using cough medications like expectorants and cough suppressants.

Respiratory Care Techniques

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• Chest physiotherapy

  • Includes percussion, vibration, and postural drainage.

  • Helps loosen and mobilize secretions.

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• Suctioning the Airway

  • Indicated to maintain a patent airway and remove secretions or foreign material.

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• Meeting Oxygenation Needs

  • Using bronchodilators, mucolytic agents, and corticosteroids.

  • Different delivery systems like nebulizers and metered-dose inhalers.

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• Dry powder inhalers

  • Device delivering medication in dry powder form.

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• Providing Supplemental Oxygen

  • Can increase oxygen transported in the blood.

  • Administered through various delivery systems.

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• Positive Airway Pressure (PAP)

  • Uses air pressure to keep airways open.

  • Treats disorders like sleep apnea and heart failure.

Oxygen Administration and Airway Management

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• Precautions for Oxygen Administration

  • Avoid open flames, smoking, synthetic fabrics, and oils.

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• Using artificial airways

  • Preserves a functioning airway in patients.

  • Includes oropharyngeal and nasopharyngeal airways, tracheostomies, or endotracheal tubes.

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• Managing Chest Tubes

  • Used for draining fluid, blood, or air in the pleural space.

Emergency Procedures

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• Clearing an obstructed airway

  • Differentiates between partial and complete airway obstructions.

  • Recommends actions like the Heimlich maneuver for complete obstructions.

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• Administering Cardiopulmonary Resuscitation (CAB)

  • Involves chest compressions, airway management, breathing, and defibrillation.

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• Cardiopulmonary resuscitation