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Problems of Oxygenation VentilationMedical Surgical Nursing

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What is a benefit of an arterial catheter?
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It permits continuous monitoring of intraarterial blood gasses without repreated arterial punctures
T/F Normal PaO2 decreases with advancing age and in higher altitudes.
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True.
Which patients need careful evaluation before they are cleared for air travel, and why?
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Patients that are on oxygen therapy or have a PaO2 of less than 72 mm Hg because air travel causes a decrease of 16-32 mm Hg in a normal adult
How is oxygen delivery to tissues or oxygen consumption measured in patients with impaired cardiac output or hemodynamic instability?
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Through a pumonary artery (PA) catheter
What is the major difference between blood retrieved for an ABG and blood retrieved through a PA catheter?
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ABG blood is arterial PA Catheter blood is mixed venous blood
What is a normal SpO2 reading?
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95% and above
What principle guides the use of pulse oximetry?
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Saturated blood absorbs light differently than deoxygenated blood does. A pulse Ox measures the amount of light that passes from a light-emitting diode through a part of the patient's body to a photodetector on the other side
Why is pulse oximetry a valuable assessment tool in inteisve care and perioperative situations?
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Sedation or decreased consciousness may mask hypoxia
T/F Pulse oximetry are all that is needed to determine ventilation and acid-base balance.
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False, an ABG is also periodically needed
A patient's SPO2 has been measured with a pulse oximetry. It is reporting a value of 70%. You know this reading might be inaccurate because...
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If the patient's SPO2 is less than 70%, it can be 4% off either way from the actual value (so 66%-74%).
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A woman brings her husband into the ER stating she found him in a closed garage with the engine running. His pulse ox reading is 97%. Do you breathe a sigh of relief with the wife?
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Not yet, if the hemoglobin is bound to something other than oxygen (like carbon monoxide, for which it has even a higher affinity) the pulse ox can be incorrect, reflecting instead the amount of hemglobin bound to carbon monoxide (in which case, the patient is probably toast).
What factors can alter the accuracy of a pulse ox reading?
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Patient motion, low perfusion, anemia, cold extremities, bright fuorescent lights, intravascular dyes, thick acrylic nails or dark complected skin.
What does a decreased SVO2 suggest?
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That less oxygen is being delivered to the tissues or that more oxygen is being consumed.
What can changes in a SVO2 be an early warning of?
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Changes in cardiac output or tissue oxygen delivery
What is a normal SVO2?
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60-80%
What are early signs of inadequate oxygenation?
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Apprehension, restlessness or anxiety, irritability, tachypnea, tachycardia, and mild HTN.
What is usually the first sign of hypoxemia and why?
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Apprehension, restlessness or irritability because the brain is very sensitive to decreased oxygen delivery (and these are all CNS symptoms)
An SPO2 value of _______% or less while at rest denotes a need for continuous or supplmental oxygen.
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88%
Central chemoreceptors for respiration are located in the _________ and response to changes in ________.
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Located in the medulla and respond to changes in H+ concentrations
Changes in PaCO2 regulate ventilation primarily by their effects on the pH of _________.
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Cerebrospinal fluid
Where are the peripheral chemoreceptors for respiration located?
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-In the carotid bodies at the bifurcation of the common carotid artery -In the aortic bodies above and below the aortic arch
  
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