Oxygenation

Motor Cortex
Chemoreceptors: Detect changes in blood gases.
- Peripheral Chemoreceptors: Sensitive to O2, CO2, and H+ levels.
- Central Chemoreceptors: Located in the medulla, primarily respond to CO2 levels.
Lung Receptors: Include stretch receptors that respond to lung expansion and irritant receptors that may trigger reflexes.
Other Receptors:
- Pain receptors and emotional stimuli through the hypothalamus.
Higher Brain Centers: The cerebral cortex allows voluntary control over breathing.
Respiratory Centers: Located in the medulla and pons, responsible for automatic control of breathing.

Airway Function: Moisten, warm, and filter incoming air.
- Upper Airway: Composed of nasal cavity, pharynx, larynx.
- Lower Airway: Includes trachea, bronchi, lungs.
Lungs: Consist of alveoli encased in capillary networks for O2 and CO2 exchange.
Pulmonary Circulation: Facilitates the movement of blood and gases within the lungs.

Ventilation (Inhalation/Expiration): Movement of air in and out of the lungs.
- Lung Compliance: The ability of the lungs to expand easily.
- Lung Elasticity: The ability of the lungs to return to their original size after expansion.
- Airway Resistance: The diameter of the airway affects airflow; narrowing increases resistance.
Respiration: The exchange of O2 and CO2 across the pulmonary capillaries, which can be affected by chronic disease.

External Respiration: Gas exchange between alveoli and pulmonary capillaries.
Internal Respiration: Gas exchange between tissue cells and systemic capillaries.
Blood Flow: Transport of O2 and CO2 in the circulatory system.

Developmental Stages: Changes in pulmonary function from preterm infants to older adults.
Environmental Factors: Stress, allergies, air quality, altitude influences lung function.
Lifestyle Factors: Pregnancy, occupation, substance use (including smoking and vaping).
Medications: Impact on pulmonary function includes opioids, non-selective beta-blockers, beta-2 adrenergic agonists, steroids.
Infections and Chronic Diseases: Include conditions such as embolism, spinal cord injuries, amyotrophic lateral sclerosis (ALS).

History: Collecting patient history related to respiratory function.
Physical Exam: Includes inspection, palpation, auscultation.
- Breathing Pattern: Observations such as nasal flaring, retractions, use of accessory muscles.
- Cough Assessment: Evaluating type (productive vs. non-productive).

Orthopneic Position: Sitting position where the individual leans slightly forward with arms supported, often used in cases of dyspnea when lying down.
- Allows greater chest expansion and use of accessory muscles for breathing.

Laboratory Tests: Various labs to assess oxygenation status.
Pulse Oximetry: Measures the saturation of oxygen in the blood; factors affecting accuracy include patient movement and peripheral blood flow issues.
Pediatrics Consideration: Specific considerations for pulse oximetry in children.
Peak Flow Monitoring: Particularly useful for asthma patients to monitor lung function.

Ineffective Airway Clearance: Related to secretions (for example, infection) as evidenced by crackles.
Ineffective Breathing Pattern: Abnormal respiratory patterns needing intervention.
Impaired Gas Exchange: Lack of proper gas exchange across respiratory membranes.
Spontaneous Ventilation Impairment: Difficulty in ventilating naturally.
Risk for Aspiration: Increased risk for substance entering the airway.

Client Positioning: Utilizing positions such as the tripod position and promoting frequent position changes.
Incentive Spirometry: Device to encourage deep breathing and lung expansion.
Mobilizing Secretions: Techniques for airway clearance include turning, coughing, and deep breathing (TCDB) and chest physiotherapy.
Oxygen Therapy: Administration of oxygen at concentrations greater than 21%, with various devices used based on patient condition.
Medication Administration: Use of bronchodilators and anti-inflammatory agents to support respiratory function.

Nasal Cannula: Flow rate of 1–6 L/min delivering 24%–44% O2. Best for stable patients allowing for oral intake.
Simple Face Mask: Flow rate of 5–10 L/min delivering 35%–50% O2 for short-term use.
Non-Rebreather Mask: Flow rate of 10–15 L/min delivering 60%–90% O2; used in acute respiratory distress.
Venturi Mask: Flow rate of 2–15 L/min delivering 24%–60% O2; suitable for patients requiring precise O2 concentrations (e.g., COPD).
High-Flow Nasal Cannula: Flow rate up to 60 L/min delivering oxygen concentrations from 21% to 100% for severe respiratory failure; provides heated and humidified air.

Prone Position: Patients advised to lie prone on their stomachs if SpO2 levels fall below 94%, for a period of 30 minutes to 2 hours to improve breathing and oxygen saturation levels.