1. Oxygenation By Diana Blum MSN NURS 1510

2. Oxygen is clear odorless gas 3 components for respiration Breathing Gas exchange Transportation Structures Upper airway Lower Airway

3. Pulmonary Ventilation Factors that affect ventilation Clear airway Intact CNS Intact Thoracic Cavity

4. Alveolar Exchange After ventilation occurs, diffusion begins Pressure differences can alter

5. Transportation Third part in respiratory process O2 from lungs to tissues Factors that alter Cardiac output Number of erythrocytes and hematocrit Exercise

6. Regulation Medulla oblongata is center of regulation 3 blood gases that can affect regulation process CO2 has biggest effect

7. Factors that affect function Age Environment Lifestyle Stress Medication Health status

8. Alterations in function Hypoxia Breathing patterns Obstruction

9. Assessment Exam Diagnositics PFTs ABGs Sputum specimens Diagnosis Ineffective Airway Clearance Ineffective breathing pattern Impaired gas exchange Activity intolerance Plan Maintain airway Improve breathing Maintain ventilation Prevent complications Implementation Position TCDB IS O2 Hydration Medication

10. O2 delivery methods

11. Cannula Most common Does not interfere with eat/drink Delivers low concentration o2 2-6 liters/min Skill 50-1

12. Face Mask Simple Delivers o2 at 40-60%concentration 5-8 liters of o2 Venturi O2 concentration at 24%-50% 4-10 liters of o2 depends on adaptor Blue=24% at 4 liters Green= 35% at 8 liters Partial rebreather Has reservoir bag attached for rebreathing partial amount of exhaled air Delivers concentration at 60-90% 6-10 liters of o2 Non rebreather Highest concentration of o2 at 95-100% 10-15 liters of o2 Valves on the mask prevent room air from getting in Face tent Used when pts don’t tolerate mask Varying o2 concentrations Inspect for moisture on skin

13. Artificial Airways

17. Suctioning Open vs Whistle Whistle not as irritative Yankour Assess for respiratory distress or inability to cough Signs of needed suction Dyspnea Bubbling Rattle sounds Cyanosis Decrease in o2 sats Skill 50-2 and 50-3 Complications: hypoxemia, trauma, infection, dysrhythmias

18. Trach care Clean tracheostomy tubes every 8 hours or per policy/need Always have an assistant present Stay sterile Keep skin clean and dry Stress importance of handwashing skills Teach signs and symptoms of infection Some trachs have disposable cannulas Check it for amount and type of drainage Then place a new cannula in place ALWAYS CHECK TIES DOCUMENT SUCTIONING, CARE,DRESSING CHANGES, ASSESSMENT

19. CHEST TUBES Used for collapsed lungs, fluid in pleural space May be connected to suction 2 Types WET VS DRY Keep below the level of the chest for proper drainage and pressure Heimlich Valve One way flutter valve for ambulatory pts Assessments Monitor drainage Vitals Monitor dressing Monitor pain Encourage position changes to facilitate drainage Check water seal and suction Monitor for disconnection or leaks