Oxygen

• portable negative pressure suction device, drains blood and fluid, after abdominal, orthopedic . accordion springs/ constant suction/ requires larger amount of drainage
• Gas exchange

  intake of oxygen and the release of carbon dioxide.
• Gas exchange Happens by

  pulmonary ventilation, respiration, and perfusion.
• Respiratory System

  The airway, begins at nose and ends at the terminal bronchioles, is a pathway for the transport and exchange of oxygen and carbon dioxide.
• Lung

  Main organ of respiration = gas exchange *Right lung has 3 lobes / left has 2 lobes [made up of elastic tissue, alveoli,surfactant, and pluera]
• At end of the terminal bronchioles there are clusters of alveoli, (small air sacs). The alveoli are the site of gas exchange.
• Inspiration

  active phase of breathing in
• Expiration

  active phase of ventilation out
• Perfusion

  the process by which oxygenated capillary blood passes through body tissues.
• Hypoxia (low O2) Signs and symptoms

  Signs: Restlessness*, anxiety, confusion, drowsiness

  Symptoms: Dyspnea, elevated BP, Increased respiratory rate/ pulse rate., pallor, cyanosis
• Hypoxia (low O2) Causes and assessment

  Causes: hypoventilation, pneumonia, pulmonary embolism, collapsed lung, necrotic overdose, cardiac dysfunction

  Assess: Hemoglobin (Hgb) levels, pulse ox
• Interventions of Hypoxia (low O2)

  administer O2 via mask/ nasal cannula about 2-3L , monitor if effective (should be quick; 30 seconds), promote rest, check if able to clear secretions/ airway is clear, teach deep breathing/cough exercises, encourage/teach why important, may need suction, assess level of consciousness
• Emphysema

  a chronic lung condition, that result in decreased elasticity of lung tissue, which decreases compliance.
• Atelectasis

  Incomplete lung expansion or the collapse of alveoli; prevents pressure changes and the exchange of gas by diffusion in the lungs. cannot fill function of respiration
• Dyspnea

  difficulty breathing
• Hypoventilation

  decreased rate or depth of respirations
• Hyperventilation

  increased rate and depth of respirations
• Cardiovascular System [ heart and blood ]

  “Perfuse”

  Oxygen is carried in the body via plasma and red bloodcells

  Most oxygen (97%) is carried by red blood cells

  Hemoglobin also carries carbon dioxide / big part of gasexchange

  Want to monitor Pulse Ox!
• Anemia

  a decrease in the amount of red blood cells, results in insufficient hemoglobin available to transport oxygen [ low RBC, low hemoglobin ]
• Narcotic/ Sedatives can cause respiratory depression or arrest
• Dysrhythmia and Arrhythmia

  irregular pattern of heartbeats (cannot eject blood out, affects oxygen

  levels)
• Dysrhythmia and Arrhythmia symptoms

  dizziness, low blood pressure, palpations, weakness, fainting
• Angina


  heart pain/ discomfort (heart cannot contract well)
• Myocardial Infraction

  low oxygen supply to heart, caused by insufficient blood supply, leas to impaired oxygenation of tissues in the body
• Myocardial Infraction Symptoms

  pain, anxiety, nausea, vomiting, indigestion, shortness of breath
• Respiratory Function in Older Adult

  * kyphosis: curvature of spine, bend over hunch back, affects breathing because cannot take deep breaths

  • *  barrel chest; compensated breathing due to different lung formation [ COPD; clubbing (smoking is bigfactor), emphysema ]
  • *  The chest is unable to stretch as much, resulting in a decline in inspiration and expiration. Airwayscollapse more easily.
  • *  increase risk for pneumonia, flu
  • *  increase risk for secondary hospital acquired diseases
• Patients with renal or cardiac disorders have compromised respiratory functioning because of fluid overload and impaired tissue perfusion.
• Tachypnea

  increased respiratory rate/ rapid breathing
• What can cause Tachypnea

  [fever, anxiety, shortness of breath]
• What can cause Bradypnea

  [respiratory depression due to brain damage, narcotic overdose]
• Cheyne-stokes

  alternating periods of deep, rapid breathing followed by periods of apnea
• Bradypnea

  decreased respiratory rate/ slow breathing
• What can cause Cheyne-stokes

  [drug overdose, heart/kidney failure, intracranial pressure from severe brain injury, end of life (hospice) nearing death]
• What are normal breath sounds

  Vesicular

  Bronchial

  Bronchovesicular
• Vesicular

  low-pitched, soft sound during expiration heard over most ofthe lungs
• Bronchial

  loud, high-pitched, heard over the trachea and larynx [throat, above clavicle]
• Bronchovesicular

  medium pitch blowing sounds heard over the major bronchi
• Abnormal (Adventitious) Lung Sounds

  Crackles (rales)

  Wheezes

  Rhonchi (sonorous wheeze)

  Stridor
• Crackles (rales)

  intermittent popping sounds, occur when air moves through airways that contain fluid or with deflated small airways/ alveoli “Rice crispy” IN LOWER LOBES*
• When would Crackles (rales) manifest

  [ with inspiration, due to congestion, inflammation, pneumonia, heart failure, COPD ]