Unit-IX

Oxygenation: Respiratory Function & Cardiovascular system

By

Ms sonia bibi.

PRN BSN

1

OBJECTIVES

Identify factors that can interfere with effective oxygenation of body tissues.

• Describe common manifestations of altered respiratory and cardiovascular function.
• Discuss lifespan-related changes and problems in respiratory function and cardiovascular system.
• Describe nursing measures to ensure a patient airway.

​

​

​

​

��

������� ��

2

Objectives cont..

• Apply Nursing Process and teaching plan for a client with altered respiratory function and cardiovascular function.
• Recognize the emergencies related to respiratory and cardiovascular system.
• Explain ways that caregivers can decrease the exposure of clients to infection.
• Differentiate between medical and surgical asepsis.��������

3

Oxygenation

• Oxygen is a colorless , odorless , tasteless and combustible gas.
• Oxygen therapy is defined as the administration of oxygen by inhalation from a cylinder , piped in system liquid oxygen concentration by various methods to relieve anoxemia .
• Purpose
• facilitate normal metabolism of the tissues.
• Relive dyspnea .
• Reduce/prevent hypoxemia.
• Increase oxygen saturation.

​

4

Oxygenation

• Oxygenation is the delivery of oxygen to the body tissues and cells.
• Physiology of oxygenation.
• The delivery of oxygen to body cells is a process that depends on the interplay of the pulmonary, hematologic and cardiovascular systems.
• Specifically, the process involved include: ventilation, alveolar gas exchange, oxygen transport and delivery and cellular respiration.

5

Oxygen transport and delivery

• Once the diffusion of oxygen across the alveolar- capillary membranes occurs, the oxygen molecules are dissolved in blood plasma.
• Three factors influence the capacity of blood to carry oxygen:
• The amount of oxygen dissolved in plasma.
• The amount of hemoglobin.
• The tendency of hemoglobin to with oxygen

6

Cardiovascular Physiology

• Structure and function.
• Myocardial pump.
• Myocardial blood flow.
• Coronary artery circulation.
• Systemic circulation.
• Blood flow regulation: cardiac output, contractility,Conduction system 

7

Respiratory Physiology

• Structure and function.
• Breathing_inspiration, expiration.
• Lung volumes and capacities.
• Pulmonary circulation.
• Respiratory gas exchange, oxygen, carbon dioxide.
• Regulation of respiration.

8

Factors Affecting Oxygenation

Physiological factors:

Cardiac related

Conduction system and branches

Impaired valvular function

Myocardial hypoxia

Cardiomyopathy conditions

Peripheral tissue hypoxia

Respiratory related

Hyperventilation

Hypoventilation

Hypoxia

​

9

continue

• Decreased oxygen-carrying capacity Decreased inspired oxygen concentration Hypovolemia
• Increased metabolic rate
• Conditions affecting chest wall movement

​

​

10

continue

• Musculoskeletal and nervous system related
• Musculoskeletal abnormalities
• Trauma
• Neuromuscular diseases
• Central nervous system alterations
• Chronic disease

11

common manifestations altered respiratory system

• Acute obstructive air way diseases.
• Upper respiratory tract infection.
• Lower respiratory tract infection.
• Neurological disease.
• Traumatic injury.
• COPD
• Pulmonary edema
• Industrial diseases.

12

common manifestations altered cardiovascular system

• Coronary artery diseases.
• atherosclerotic heart diseases.
• Valvular heart disease 
• Cardiomyopathy 
• Heart rhythm
• Heart infections
• Angina 
•  heart attack
• High blood pressure
• Heart failure
• �

�

13

lifespan-related changes and problems in respiratory function

• How well the lungs supply the body with oxygen seems to relate directly to age.
• The amount of oxygen delivered to the bloodstream and the rate of blood flow declines with age.
• The number of functional alveoli decreases as the alveolar walls become thin, the aveoli enlarge, are less elastic.
• Decreased elasticity of the lungs
• The loss of elasticity accounts for "senile hyperinflation

14

continue

• Less oxygen in the system cuts down the amount of work that can be done.
• The number of cilia & their level of activity is reduced.
• Glandular cells in large airways are reduced.
• Decreased number of nerve endings in larynx.
• The cough reflex is blunted thus decreasing the effectiveness of cough.
• Decreased levels of secretory in nose & lung.

​

15

lifespan-related changes and problems in cardiovascular system.

• Deposits of the "aging pigment," lipofuscin, accumulate. Any of the minute, yellow-brown, lipogenic pigment granules that accumulate in the muscles of heart.
• The valves of the heart thicken and become harder.
• The number of pacemaker cells decrease and fatty & fibrous tissues increase about the SA node. These changes may result in a slightly slower heart rate.
• A slight increase in the size of the heart, especially the left ventricle, is common. 

16

continue

• The heart wall thickens, so the amount of blood that the chamber can hold may actually decrease.
• Age changes make the heart less able to pump efficiently.
• Less blood pumped results in lowered blood oxygen levels.
• The limits of the heart to exert itself are reduced with age.
• Medications processed and eliminated differently than in young adults.

17

��Describe nursing measures/action to ensure a patient airway.�Or role of nurse��

• Assess the airway for patency.
• Use manual methods to open an obstructed airway.
• Use basic airway adjuncts to intervene if the airway is compromised, e.g. suction, oral airway
• Assist in the maintenance of the airway using advanced airway adjuncts, e.g. intubation, surgical airway.

​

18

Cont..

• Deliver O2, when required, using appropriate methods
• Continually assess airway patency and ventilatory status of the patient using clinical observation and relevant monitoring.
• Explain procedures clearly to the patient and any family members

�

19

Recognize the emergencies related to respiratory

General indications of respiratory distress Breathing Difficulty.

• Shortness of breath.
• Restlessness, agitation .
• Drop in pulse oximeter •
• Abnormal respiratory rates •
• Cyanosis or pallor.
• Abnormal breath sounds
• Inability to speak well • Thoracic and neck retractions • Diaphragmatic breathing
• Altered mental status
• Nasal flaring.

20

Emergency medical care related respiratory system

• Keep airway and ventilatory equipment available as respiratory distress patients tend to deteriorate rapidly Breathing Difficulty.
• Inadequate breathing.
• Establish an open airway.
• Determine what interventions the patient has used
• Determine what medications patient takes (types, doses, times used)

21

Cont…

• Continue monitoring airway and breathing.
• Complete the history and physical exam.
• Place the patient in a position of comfort, most typically a Fowler’s or semi-Fowler’s
• Begin transport Breathing Difficulty.

22

Emergency medical care related cardiovascular system

​

•  Attach cardiac monitoring, and obtain a 12-lead ECG.
•  Establish IV.
• collect blood for CBC, U&E, clotting.
•  Ensure pain relief.
•  Request CXR, if indicated.
• Reassure, and offer support and comfort to the patient and family.
• minimizing anxiety as much as possible.

�����

23

CONT…

• Early recognition.
• Early CPR.
• CAUSES 
• Heart tumors
• Hypothyroidism
• Kidney failure
• Leukemia
• Radiation therapy to the chest
• open heart surgery 

​

24

Explain ways that caregivers can decrease the exposure of clients to infection.

• Hand washing.
• Use of personal protective equipment
• Appropriate handling of patient care equipment and soiled linen.
• Prevention of needlestick/sharp injuries Environmental cleaning and spills- management.
• Appropriate handling of waste

25

CONT…

26

��������� Differentiate between medical and surgical asepsis.���������

27

28