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what does the use of accessory muscles indicate - ✔✔an attempt to increase
lung volume that results in fatigue is not effective ventilation. indicates
ventilatory fatigue, air hunger, or decreased lung expansion
how does oxygenation of tissues take place - ✔✔ventilation; the process of
moving gases into and out of the lungs
perfusion; the cardiovascular system pumping oxygenated blood to the
tissues and return deoxygenated blood to the lungs
diffusion; exchange of respiratory gases in the alveoli and capillaries
how are respirations regulated (chemical and neural) - ✔✔neural
regulation- CNS controls the respiratory rate, depth, and rhythm and
cerbral cortex control voluntary respirations
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,chemical regulation - maintains the rate and depth of respirations based on
changes in the blood concentrations of CO2 and O2 and in pH, SO the
chemoreceptors sense these changes in chemicals and stimulate the
nervous system to adjust
Factors affecting oxygenation - physiology - ✔✔decreased o2 carrying
capacity, hypovolemia (low blood volume, less hemoglobin to carry O2
through vessels), decreased inspired O2 conc., increased metabolic rate
(infection, sepsis),
factors affecting oxygenation - chest wall movement - ✔✔prgnancy,
obesity, neuromuscular disease, musculoskeletal deformities, trauma,
alterations to CNS
COPD and oxygenation - ✔✔-these pts have adapted to a high level of
CO2, so the CO2 sensitive receptors do not function
-COPD pts stimulus to breathe is low O2, while normally it is high CO2
-receptors in the aortic arch and carotid bodies are sensitive to low O2 level
causing increased ventilation when low O2
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,-SO, administering high levels of O2 to these pts prevents their O2 level
from falling and stimulating the receptors, which REMOVES THEIR
STIMULUS TO BREATHE
hyper and hypo ventilation - ✔✔hyper- breathing in excess of what is
required to remove CO2
hypo- inadequate breathing to meet bodys O2 demands or needs to
eliminate CO2
nursing notes on oxygenation - developmental factors - ✔✔-mental status
changes are 1st sign of respiratory problem
-may not complain of dyspea until it affects ADLs
- changes in coughing mechanism may lead to retention of secretions and
atelectasis (when using cough suppressants)
-diminshed respiratory muscles from changes in thorax lead to issues w
chest expansion
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, nursing note on oxygenation - lifestyle - ✔✔smoking (heart disease, COPD,
lung cancer), substance abuse (impairs tissue perfusion), stress (increases
metabolic rate and oxygen demand of the body)
nursing note on oxygenation - environmental factors - ✔✔the incidence of
pulmonary disease is higher in smoggy, urban areas
-work place risks include asbestosis, coccidiodomycosis
thorough assessment of oxygenation and systems - ✔✔past impairments of
circulatory or respiratory function, methods pt uses to optimize
oxygenation, review of allergies, physical examination, lab and diagnostic
tests.
-HX of chest pain, dyspnea, wheezing, resp. infections, meds, fatigue,
cough, smoking, exposures
-EXAMINE skin and mucous membranes, LOC, breathing patterns, chest
wall movement, palpate chest, feet, legs, pulses, auscultate heart and lung
sounds
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