NR 224 Week 7 Core Assignment; Nursing Skill; Oxygenation

Week 7 Edapt Notes Gas Exchange A person who stops breathing will begin to experience permanent brain damage only 4 minutes after they stop breathing and death will occur in as soon as 8-10 minutes (MedlinePlus, n.d.). An oximeter measures the saturation of hemoglobin with oxygen. When gas exchange is impaired, both the lungs and heart can compensate for a limited time by altering the respiratory rate, heart rate, or both, allowing the body to return to homeostasis (not disequilibrium). When compensatory mechanisms fail, the result may lead to tissue and organ damage or death. 457200146023 Oxygen saturation 78% - oxygen Cannot take a deep breath – ventilation device Asthmatic wheezing – inhaled medication Stopped breathing – ventilation device With an abnormal lung assessment and a normal heart assessment, the best recommendation to consider would be a chest x-ray for impaired gas exchange diagnosis. The abnormal blood pressure and heart rate are compensation for the hypoxia. The respirations are increased in response to the low serum oxygen saturation (hypoxemia) caused by pneumonia interfering with gas exchange in the alveoli. Administering supplemental oxygen to increase the oxygen saturation is the priority action for hypoxemia. Based on the assessment findings, the client’s impaired gas exchange is most likely a result of a cardiac abnormality (hypotension, tachycardia, and systolic murmur). The most likely pathophysiological condition causing this impaired gas exchange is a myocardial infarction. The echocardiogram showed normal valve function, the electrocardiogram did not show dysrhythmia, and none of the tests done would show a pulmonary embolus. However, blockage of the artery, elevated Troponin level, and ST elevation on the electrocardiogram all show myocardial infarction. Oxygen Devices Oxygen cylinder colors in U.S.: Green is the U.S. designation for oxygen in a cylinder. Blue is the U.S. designation for nitrous oxide. Yellow is the U.S. designation for medical air. Gray is the U.S. designation for carbon dioxide. A regulator is necessary to determine the flow of oxygen. Oxygen is a medication and requires a provider's order to administer. 457200164455 When using nasal cannulas, the flow of oxygen can dry the nasal mucosa. Contacting the healthcare provider to request adding humidification is the best option. 526831214138 CPAP uses one continuous pressure with inspiration and expiration. BiPAP uses a different pressure for inspiration than for expiration. Both have the ability to provide supplemental oxygen at any setting. Both require a good mask with a seal. A bag-valve-mask delivering 50% oxygen is the best replacement device and the only one that offers support for ventilation along with oxygen delivery. 526633210587 Tracheostomy Care Trauma-causing upper airway obstruction, laryngectomy, and long-term ventilator use are all reasons for tracheostomy placement. Tracheostomy care is done every shift, or twice to three times per day. The pilot balloon signals if the cuff is inflated or deflated. The pilot balloon is only used on tracheostomy tubes with a cuff. These balloons have a valve to attach a syringe and allow for air to be injected to inflate the cuff and air to be