Oxygen 7

Foundations of Nursing

Topic 7: Oxygenation

Chapter 41: Oxygenation Part I

Scientific Knowledge Base

Respiratory Physiology

• Understanding the structure and function of the respiratory system.

• Work of breathing: Includes factors influencing the effort required to breathe.

• Lung Volumes: Different functional and anatomical lung capacities.

• Pulmonary Circulation: Movement of blood from heart to lungs for oxygenation.

Respiratory Gas Exchange

• Mechanisms of gas exchange in the lungs.

• Oxygen transport: How oxygen is carried in the blood through hemoglobin.

• Carbon dioxide transport: The processes by which CO2 is carried away from tissues.

• Regulation of ventilation: The control mechanisms influencing breathing rates.

Cardiovascular Physiology

• Structure and function of the heart.

• Myocardial pump: Refers to how the heart muscles contract to pump blood.

• Myocardial blood flow: Understanding blood supply to the heart muscle itself.

Key Heart Structures

• Blood Vessels:

  • Superior vena cava

  • Inferior vena cava

  • Aorta

  • Pulmonary artery

• Chambers:

  • Right atrium, Right ventricle, Left atrium, Left ventricle

• Heart Valves:

  • Tricuspid valve

  • Mitral valve

  • Pulmonic (semilunar) valve

  • Aortic (semilunar) valve

• Other Components:

  • Chordae tendineae

  • Papillary muscle

  • Interventricular septum

Cardiovascular Physiology Continued

• Coronary artery circulation: Blood flow to heart muscles.

• Systemic circulation: Blood flow to the rest of the body.

• Blood flow regulation: Mechanisms controlling blood flow and pressure.

• Conduction system: Electrical system controlling heartbeats.

Cardiac Output

• Definition: The amount of blood the heart pumps per minute.

• Formula: Cardiac Output (CO) = Heart Rate (HR) x Stroke Volume (SV).

• Importance in assessing cardiac function.

Factors Affecting Oxygenation

Physiological Factors

• Decreased oxygen-carrying capacity: Conditions like anemia.

• Hypovolemia: Low blood volume impacting organ perfusion.

• Decreased inspired oxygen concentration: Conditions affecting air quality.

• Increased metabolic rate: Higher demand for oxygen in the body.

Conditions Affecting Chest Wall Movement

• Pregnancy: Expansion reduces lung capacity.

• Obesity: Increased weight limits lung expansion.

• Musculoskeletal abnormalities: Affect physical breathing capability.

• Trauma: Can affect chest wall integrity and function.

• Neuromuscular diseases: Impair control over breathing.

• Chronic lung disease: Limits airflow and gas exchange efficiency.

Alterations in Respiratory Functioning

• Hypoventilation: Decreased rate/depth of breathing results in inadequate oxygen.

• Hyperventilation: Increased rate/depth; displacement of CO2.

• Hypoxia: Low oxygen levels in tissues.

Alterations in Cardiac Functioning

• Disturbances in conduction: Issues with electrical signals in heart.

• Altered cardiac output: Changes in the heart's efficiency.

• Left-sided heart failure: Blood backs up into the lungs.

• Right-sided heart failure: Blood backs up into the body.

Continued Alterations

• Impaired valvular function: Issues with heart valves.

• Myocardial ischemia: Reduced blood flow to heart.

• Angina: Chest pain due to ischemia.

• Myocardial infarction: Heart attack due to blocked blood flow.

Case Study – Mr. King (Part 1)

• Details: 62-year-old man, chest pain, shortness of breath, cough, and malaise.

• History: Chronic obstructive pulmonary disease (COPD), alcohol abuse, heavy smoking.

• Barriers to health: Chronic illnesses affecting activity and quality of life.

Factors Influencing Oxygenation

Nursing Knowledge Base

• Developmental stage of the patient impacts oxygenation: Infants to older adults have different requirements.

• Lifestyle factors affect oxygenation: Nutrition, hydration, exercise, smoking, and stress.

Critical Thinking in Nursing

• Knowledge of physiology provides a basis for patient assessments.

• Critical thinking leads to methodical actions in patient care.

• Professional standards guide effective patient management.

Clinical Decision Making

• Recognize patient cues and assess signs of impaired oxygenation.

• Evaluate environmental factors like medical devices and available resources.

• Address risk factors for impaired oxygenation and consider developmental aspects.

Case Study – Mr. King (Part 3 & 4)

• John’s approach: Evaluate Mr. King’s condition; address his distress effectively.

• Understanding of pulmonary conditions helps in managing Mr. King's symptoms and encouraging smoking cessation.

References

• Potter, P., Perry, A., Stockert, P., & Hall, A. (2023). Fundamentals of nursing (11th ed.). Elsevier.

Questions

• Contact assigned course instructor for any questions regarding content presented.