NUR102 MOD K&I

Module K Objectives

  • Define terms associated with oxygenation
  • Explain the physiology of oxygenation
  • Explain the process of oxygen administration
  • Explain the process of nasopharyngeal suctioning
  • Explain the process for specimen collection
  • Identify diagnostic values related to oxygenation
  • Explain pulse oximetry
  • Explain the process of connecting a pulse oximeter
  • Identify emergency techniques for restoring oxygenation
  • Explain the process of using various emergency techniques for restoring oxygenation
  • Explain the process of applying the nursing process to maintaining oxygenation

Module I Objectives

  • Define terms associated with comfort, pain, sleep, and rest
  • Explain techniques to promote comfort
  • Explain techniques to manage pain
  • Explain the process of promoting sleep
  • Explain the process of promoting rest
  • Explain the application of the nursing process in managing comfort, pain, sleep, and rest.

Module K

  • Reference Materials:
      - Potter and Perry Chapter 41
      - ATI Chapter 53

Vocabulary

  • Afterload
  • Angina
  • BiPAP
  • Bradycardia
  • Cardiac Output
  • Chest Physiotherapy (CPT)
  • COPD
  • CPAP
  • Diffusion
  • Electrocardiogram (ECG)
  • Furosemide
  • Hemoptysis
  • Hypoxemia
  • Hypoxia
  • Humidification
  • Incentive Spirometry
  • Myocardial Ischemia
  • Modifiable Risk Factors
  • Non-modifiable Risk Factors
  • Orthopnea
  • Preload
  • Pursed-lip Breathing
  • Stroke Volume
  • Subcutaneous Emphysema
  • Ventilation

Physiology of Oxygenation

  • The right lung comprises three lobes, while the left lung consists of two lobes.
  • The lungs are responsible for bronchodilation (expansion of the airway) and bronchoconstriction (restriction of the airway) related to both parasympathetic and sympathetic nervous systems.

Terms Related to Oxygenation

  • Hypoxemia: A condition characterized by a limited amount of oxygen in the blood.
  • Retractions: An inward pulling of muscles between ribs during inspiration; can be a sign of airway obstruction.
  • Hypoxia: A state in which there is inadequate oxygen at the cellular or tissue level.

Symptoms and Manifestations of Oxygen Deficiency

  • Symptoms of hypoxemia and hypoxia include:
      - Confusion
      - Irritability
      - Restlessness
      - Dyspnea
      - Tachypnea
      - Tachycardia or bradycardia
      - Cyanosis

Causes of Hypoxemia

  • Potential causes include:
      - Anemia
      - Pneumonia
      - COPD (Chronic Obstructive Pulmonary Disease)
      - Asthma
      - Acute Respiratory Distress Syndrome (ARDS)
      - Pneumothorax
      - Pulmonary embolism
      - Pulmonary edema

Gas Exchange Process

  • Breathing involves inhalation of oxygen and exhalation of carbon dioxide through gas exchange.
  • The sequence of gas exchange is as follows:
      1. Air flows through nasal passages and mouth to the lungs.
      2. Air passes by the epiglottis directing air toward the lungs.
      3. Travels down the trachea and into the bronchi.
      4. Bronchi branch into smaller bronchioles leading to alveoli, where gas exchange occurs with surrounding capillaries.
      5. Oxygen from alveoli enters blood, while carbon dioxide diffuses out of the blood into the alveoli.

Lung Structure and Function

  • Lung Compliance: The ability of the lung to stretch and expand.
  • Airway Resistance: The resistance met by airflow in the respiratory pathways.
  • Accessory muscle use indicates respiratory distress, often due to increased work of breathing.

Pulmonary Circulation

  • Deoxygenated blood is routed from the right ventricle to the lungs via the pulmonary artery.
  • In the lungs:
      - Oxygen from alveoli enters the capillaries.
      - Deoxygenated blood returns to the left atrium via the pulmonary veins.

Factors Affecting Oxygenation

  • Decreased O2 carrying capacity due to factors such as anemia, high altitudes, or inadequate oxygen administration can impair transport and uptake.
  • Physiological factors such as hypovolemia (low blood volume), increased metabolic demands from fever or exercise, and other diseases can also affect oxygenation levels.

Oxygen Delivery Methods

  1. Nasal Cannula: Low flow oxygen delivery (1-6 L/min); provides 24%-44% oxygen.
  2. Simple Face Mask: Delivers 40%-60% oxygen at 5-8 L/min, used for patients with nasal irritation.
  3. Partial and Nonrebreather Masks: Must remain partially inflated; performance increases for critically ill patients. Nonrebreather masks deliver high-flow oxygen (10-15 L/min).
  4. Venturi Mask: Mixes oxygen with room air, providing precise oxygen delivery (24%-40%). Ideal in concerns of CO2 retention.
  5. High-Flow Nasal Cannula: Simple to use but expensive, allows patients to talk, eat, drink easily.
  6. CPAP and BiPAP: Devices to improve airway pressure during sleep (CPAP provides constant pressure; BiPAP provides two levels of pressure).

Pulse Oximetry

  • A noninvasive method to measure oxygen saturation in arterial blood, typically 95%-100% for healthy individuals.
  • In COPD patients, acceptable levels may drop to 88%-92%.
  • The pulse oximeter emits light that passes through the skin to measure blood oxygen levels, which is crucial in determining patients' oxygenation needs.

Nursing Interventions for Oxygenation

  • Assessing the patient's vital signs and oxygen saturation regularly.
  • Administering supplemental oxygen as indicated and monitoring for adverse effects such as hypoxia.
  • Implementing strategies such as pursed-lip breathing to enhance patient comfort and improve breathing efficiency.

Safety Guidelines for Oxygen Use

  • Do not smoke around oxygen equipment.
  • Keep oxygen away from heat sources and flammable materials.
  • Always post warning signs about oxygen usage.