NR 324 Week 2 EDAPT_Altered Gas Exchange

cause bronchoconstriction that limits gas exchange. Lifestyle / Social Recreational chemical inhalation Diet Obesity Cigarettes or any type of vape/drug inhalation can cause lung damage, leading to decreased gas exchange. Obesity can cause resistance to the diaphragm or sleep apnea, which leads to impaired gas exchange. A high-sodium diet can cause hypertension and the potential for fluid overload, leading to poor gas exchange. Vital Signs Respiratory rate Oxygen saturation Often, when there is a low oxygen level or high carbon dioxide level, the respiratory rate will increase to compensate. In addition, oxygen saturation may decrease due to altered gas exchange. Respiratory Assessment Lung sounds Abnormal lung sounds including decreased air movement, asymmetrical chest movement or deformity, or adventitious breath sounds can suggest an altered gas exchange. Lab Results Arterial blood gasses Venous blood gasses Lactic acid level Carbon dioxide level Arterial blood gasses are perhaps the most accurate indicator of an altered gas exchange. In addition, some other results can also clarify this issue, including venous blood gasses, lactic acid levels, or carbon dioxide levels. Procedure Results Computerized tomography (CT) scan Pulmonary angiogram Ventilation / perfusion Chest x-ray All types of procedures can indirectly or directly suggest there is an altered gas exchange. The most accurate direct test for gas exchange is the ventilation perfusion scan (also called a VQ scan). Review of Systems - Based on the data collected from the history and physical assessment of the client, including past medical and surgical history, procedures, lifestyle, and medications (over-the-counter or prescribed), the nurse will perform a head-to-toe assessment of the client and look at the laboratory and radiology test results. - The interprofessional care of altered gas exchange may be different based on the etiology and some of the assessment findings. - There are generally things that nurses can do to treat altered gas exchange, regardless of the etiology. - This includes actions that improve gas exchange and further assessment that may involve focusing on and treating an underlying cause. System Nursing Actions/Assessment Rational Genitourinary Monitor intake (oral or IV fluids) and output (urine). Excess fluid balance can lead to altered gas exchange. Monitoring fluid input and output can identify early signs of fluid overload. Nursing Actions: Altered Gas Exchange - Depending on the cause of the altered gas exchange, there are a variety of treatments that may be ordered by the healthcare provider. - Generally, for altered gas exchange, some actions will improve or eliminate the alteration. - Some actions the nurse may perform. - Oxygen therapy - Oxygen therapy is one of the quickest ways to improve gas exchange. - Immediately delivering oxygen by nasal cannula, mask, or another device is often done initially as part of the treatment for clients with gas exchange problems. - Chest procedures - Several things can cause an altered gas exchange. Sometimes it is constriction of the lung from inflating (blood, fluid, or infection in the pleural space). When this occurs, a thoracentesis (putting a needle or tube in the chest