Theory week 5 oxygenation

• Upper Airway


  • Warms
  • Filters
  • Humidifies
  • Conducts Air
• Lower Airway


  • Cilia
  • Mucus/Surfactant
  • Air Conduction
• Lungs


  • 5 lobes
  • Visceral Pleura
  • Parietal Pleura
  • Negative pressure in pleural space
  • Gas Exchange
  • Surfactant keeps open
• Requirements for a functional respiratory system

  • Airways
  • Functional alveoli
  • Cardiovascular function
  • Respiratory center
  • Ventilatory muscles
• Ventilation


  Movement of air in & out of the respiratory system
• Perfusion


  Passage of blood through tissues
• Problems Affecting O2/CO2 Exchange

  • Atmospheric pressure
  • Ventilation/Perfusion
  • Airway patency
  • Diffusion problems
  • O2 carrying capacity
  • Circulation
  • O2 utilization
  • Lung compliance
• Atelectasis


  Alveolar collapse
• Hypoxia


  Inadequate O2 to cells
• Hypoventilation


  Decreased rate or depth of respiration
• Hyperventilation


  Increased rate or depth of respiration
• Respiratory Assessment


  • General behavior
  • Rate, effort, breath sounds
  • Recent changes
  • Pulses
  • BP
  • Hydration status
  • Activity tolerance
  • Skin color & temperature (cyanosis, pallor, mottling)
• Factors Affecting Respiration


  • Age
  • Developmental state
  • General health/lifestyle
  • Drugs
  • Environmental
  • Psychological health
  • Physical changes
• Diagnostic Tests


  • Pulmonary function- volumes of ventilation
  • Arterial blood gases (ABGs)- gas dissolved in the blood
  • Pulse Oximetry- O2 saturation of arterial blood
  • Sputum specimen- ID's pathogens
  • Endoscopy- direct visualization
• Diagnostic Tests Cont.


  • Chest X-ray (CXR)- diagnose pulmonary disease & progress
  • Cat Scan (CT)
  • Magnetic Resonance Imaging (MRI)
  • Lung Scan (VQ)
  • Thoracentesis- aspiration of fluid from a pleural space
  • TB, allergies
• Respiratory Interventions


  • Incentive spirometer
  • Flutter valve
  • C&DB
  • HOB upright
  • VS
  • Medications as ordered
  • Breathing treatments
• Postural Drainage
• Oxygen Therapy


  • Nasal cannula
  • Simple mask
  • Simple mask with rebreather bag
  • Ventilators
  • Croup tents
  • Tracheostomy
  • CPAP/BiPAP (night)
• Respiratory Medications


  • Bronchodilators
  • Anticholinergic Bronchodilators
  • Corticosteroids
  • Leukotriene Modifiers
  • Antihistamines
  • Nasal Decongestants
  • Antitussives
  • Expectorants
• Bronchodilators


  Stimulate B2 receptors in bronchioles → dilation
• Anticholinergic Bronchodilators


  Block action of acetylcholine - prevents bronchoconstriction & mucus production
• Corticosteroids


  Potent anti-inflammatory agents
• Leukotriene Modifiers


  Prevent leukotrienes from mediating bronchoconstriction and inflammation in allergies/asthma attacks
• Antihistamines


  Histamine 1 receptor antagonists
• Non-Sedating Antihistamines


  Less side effects and drowsiness
• Nasal Decongestants


  Usually adrenergic agonists, constrict nasal arterioles
• Antitussives


  Suppress cough either locally or centrally
• Expectorants


  Liquefy respiratory secretions
• Parietal Pleura


  A type of serous membrane that lines the thoracic cavity and covers the lungs' surface. It is the outer layer of the pleura and is composed of mesothelial cells.
• Alveoli


  Tiny air sacs located at the end of the bronchioles in the lungs where gas exchange occurs between the air we breathe in and our blood.
• Ventilation


  The movement of air in and out of the respiratory system
• Respiration


  Gas exchange
• Ventilatory muscles


  • Diaphragm
• Perfusion


  The exchange of blood through tissues
• Signs and symptoms indicating lack of tissue perfusion


  • Cyanosis
  • Tachycardia
  • Weak pulses
  • Hypotension
  • Low respirations
  • Decreased capillary refill
  • Cool extremities
  • Pallor
  • Low O2 sat >90
• Signs and symptoms of inadequate oxygen intake


  • SOB
  • Rapid breathing
  • Tachycardia
  • Confusion
  • Dizziness
  • Lightheaded
  • Low O2 sat >90
• Assessing respiratory function and tissue perfusion


  1. General behavior

  2. Rate, effort, breath sounds

  3. Recent changes

  4. Pulses

  5. BP

  6. Hydration status

  7. Activity tolerance

  8. Skin color and temp

  9. Cyanosis, pallor, mottling
• Common diagnostic tests to determine oxygen intake and respiratory function


  • Pulmonary function-volumes of ventilation
  • ABG's
  • Pulse ox
  • Sputum specimen
  • Endoscopy-direct visualization
  • CXR, CT, MRI, VQ(lung scan)
  • Skin tests- allergies, TB
• Problems interfering with oxygen uptake, transport, utilization, and removal of CO2

  • Atmospheric pressure
  • Ventilation/perfusion
  • Airway patency(condition of the air passages)
• Hyperventilation


  Increased rate and depth