Question

. What factors influence oxygenation?

b. Identify illnesses and conditions that may alter oxygenation.

c. In what ways do developmental, lifestyle and environmental factors impact an individual’s oxygenation status?

d. What cues would you anticipate in a client with a compromised oxygenation status?

e. What actions related to pulmonary diagnostic testing and interventions would you anticipate being prescribed for a client with a respiratory illness or conditions?

Answer 1

(a)Factors affecting oxygenation are,

Physiological Factors

• Anemia
• Airway obstruction
• High altitude
• Fever
• Pregnancy
• Obesity
• Trauma
• CNS alterations
• Pain
• Musculoskeletal Abnormalities

Developmental Factors

• Prematurity-surfactant
• Infancy-Upper Respiratory infections (URIs)
• Adolescence-exposures
• Middle-Age-diet.exercise,  etc.
• Older Adults-Atherosclerotic plaques

Behavioral Factors

• Nutrition
• Exercise
• Smoking
• Anxiety/Stress
• Substance abuse
• Depression

Environmental Factors

• Toxic inhalants
•   Asbestosis
• Pollution
• Allergens
• Pollen

(b)Illnesses and conditions that restrict or alter oxygenation are,

1. Anemia- Decreasing oxygen carrying capacity of blood.
2. Pregnancy-Restricting the chest movements
3. COPD
4. Musculoskeletal abnormalities or neuromuscular alterations
5. flail chest
6. Emphysema
7. Surfactant defeciancy
8. smoke inhalation

(c)The devolopmental factors that affect oxygenation on the respective stages of life is quoted above under devoopmental factors.

The lifestyle factors which adversely affect include smoking,obesity,substance abuse,life in high altitude areas,over exertion,anxiety,stress etc. Daily exercises like running,walking,aerobics etc can have a positive impact on oxygenation.

The environmental factors are also listed above under the subheading 'environmental factors'

(d)The cues are

• Anxiety
• Disorientation
• Confusion
• Listlessness
• Headache
• Reduced exercise tolerance
• Fatigue
• Memory loss
• Depression
• Sleeping problems
• Cyanosis
• Irregular breathing
• Rapid heart rate
• Apnea
• Reduced blood pressure
• Ventricular fibrillation
• Polycythemia
• Cardiac arrest
• Coma

(e)Diagnostic tests include

Ventilation/O2 Studies

• Pulmonary Function Tests (PFT’s)  
• Arterial Blood Gases (ABG’s)
• Pulse Oximetry

Lab Diagnostics

• CBC (Hgb & Hct)
• Cardiac enzymes (CK-MB)  
• Troponin
• Electrolytes
• Cholesterol  
• Triglycerides

Pulmonary Visualization

• CXR
• Bronchoscopy
• Lung Ventilation- Perfusion Scan
• CT Scan of Lungs

Diagnosing Abnormal Organisms in the Respiratory Tract

• Throat Cultures (C&S)
• Sputum collection
• AFB (Acid Fast Bacillus - for Tuberculosis (TB) diagnosis)
• Cytology (for cancer)
• Skin Testing (PPD for TB diagnosis)
• Thoracentesis

INTERVENTIONS

Oxygen Therapy

• Nasal Cannula
• Simple Face Mask
• Venturi Mask
• Plastic Face Mask with inflated reservoir bag(Non-Rebreather Mask)

Nursing Interventions for Optimal Oxygenation

Promoting Lung Expansion:

1. Positioning
2. Coughing and Deep Breathing
3. Incentive Spirometry with Physician’s Order

Promoting Mobilization of Secretions

1. Hydration
2. Dependent Nursing Interventions:

• Chest PT: percussion and  vibration  (Chest Physiotherapy)
• Postural Drainage
• Relaxation Techniques

Other interventions include,

1. Airway Maintenance: humidification, nebulization
2. Suctioning: oral, nasotracheal, nasopharyngeal,
3. Artificial Airways: oral/tracheal
4. Ventilators