NAME: Cyrus Josher DC.
Mayoyo DATE SUBMITTED: April 14, 2020
SECTION: BSN 1-B SCORE: ______
WORKSHEET#4-OXYGENATION
Answer the guide questions below:
1. Describe the role and function of the respiratory system in transporting
oxygen and carbon dioxide to and from body tissues.
Transport of Oxygen and Carbon Dioxide
The third part of the respiratory process involves the transport of
respiratory gases. Oxygen needs to be transported from the lungs to the
tissues, and carbon dioxide must be transported from the tissues back to the
lungs. Normally most of the oxygen (97%) combines loosely with hemoglobin
(oxygen-carrying red pigment) in the red blood cells (RBCs) and is carried to
the tissues as oxyhemoglobin (the compound of oxygen and hemoglobin).
Various factors influence the propensity of oxygen to bind with and release
from hemoglobin. As oxygen diffuses from capillary blood into tissues, the
decreasing partial pressure of oxygen stimulates the hemoglobin to release
its attached oxygen molecules. Additionally, changes in blood pH affect the
hemoglobin’s ability to bind with and release oxygen. The small amount of
oxygen not bound to hemoglobin is dissolved and transported in the plasma
as the PaO2.
2. Identify four major types of conditions that can alter respiratory function.
Alteration in Respiratory Function
1.) Conditions affecting the airway
2.) Conditions affecting movement of air
3.) Conditions affecting diffusion
4.) Condition affecting transport
3. Describe nursing measures to promote respiratory function and oxygenation.
PROMOTING OXYGENATION
Most people in good health give little thought to their respiratory
function. Changing position frequently, ambulating, and exercising usually
maintain adequate ventilation and gas exchange. Client Teaching lists other
ways to promote healthy breathing.
When people become ill, however, their respiratory functions may be
inhibited for such reasons as pain and immobility. Shallow respirations inhibit
both diaphragmatic excursion and lung distensibility. The result of
inadequate chest expansion is pooling of respiratory secretions, which
ultimately harbor microorganisms and promote infection. Additionally,
shallow respirations may potentiate alveolar collapse which may cause
decreased diffusion of gases and subsequent hypoxemia. This situation is
often compounded by giving narcotics for pain, because narcotics further
depress the rate and depth of respiration.
Interventions by the nurse to maintain the normal respirations of
clients include:
Positioning the client to allow for maximum chest expansion
Encouraging or providing frequent changes in position
Encouraging deep breathing and coughing
Encouraging ambulation
Implementing measures that promote comfort, such as giving pain
medications.
Promoting Healthy Breathing
Sit straight and stand erect to permit full lung expansion.
Exercise regularly.
Breathe through the nose.
Breathe in to expand the chest fully.
Do not smoke cigarettes, cigars, or pipes.
Eliminate or reduce the use of household pesticides and irritating chemical
substances.
Do not incinerate garbage in the house.
Avoid exposure to secondhand smoke.
Use building materials that do not emit vapors.
Make sure furnaces, ovens, and wood stoves are correctly ventilated.
Support a pollution-free environment.
In relation in promoting respiratory function and oxygenation is deep breathing and
coughing. The nurse can facilitate respiratory functioning by encouraging deep-
breathing exercises and coughing to remove secretions from the airways. When
coughing raises secretions high enough, the client may either expectorate (spit out)
or swallow them. Swallowing the secretions is not harmful but does not allow the
nurse to view the secretions for documentation purposes or to obtain a specimen
for testing.
Application:
Jessa Mendoza is a 32-year-old secretary who was admitted to the hospital with
fever, body malaise, fatigue, cough labored respirations; and mild dehydration. The
nursing history reveals that Jessa has had a “bad cough” for several weeks that just
wouldn’t go away. She has been dieting for several months and skipping meals.
Jessa mentions that in addition to her full- time job as a secretary she is attending
second degree classes two evenings a week. She has smoked one package of
cigarettes per day since she was 25 years old.
Chest x-ray confirms Pulmonary Tuberculosis
What factors may have led the medical staff to suspect that Jessa had more
than a very bad cough? Would you have come to the same conclusion?
Base in her findings and her past history, she is experiencing fever, malaise,
fatigue, cough labored respiration, mild dehydration and she had a bad cough in a
several weeks which indicates not simple or normal cough. Thus, the medical
staff/nurse will suspect a more significant underlying condition. In addition, she has
a bad habit of taking a pack cigarettes per day, having an inappropriate kind of diet
because she also skip meals and base to her experience that show she doesn’t have
enough time to have a fully time to rest and recharge herself because she has a
fulltime job as a secretary and having a two classes in every evening a week. It will
surely indicate that her immunity is decreased because of her inappropriate habit to
herself.
If I’m the actual nurse from there, I will come up to a conclusion that she may
have a critical respiratory disease because of her major bad habit which is taking a
pack of cigarette a day and other factors that made her immunity weak. So that, I
will refer it to a doctor to run some of the laboratory procedure that will help us to
know what her really conditions are.
Once she is significantly improved, the nurse will perform discharge teaching.
What health teaching will you give regarding prevention of transmission and
improvement of health?
Pulmonary tuberculosis is a chronic disease which means it cannot be healed
in an instant because it takes time to be treated and have medication. As of now
the patient is significantly improved thus, as a nurse, short and long-term plan
discharge teaching should be addressed to help prevent the transmission of the
bacterium mycobacterium tuberculosis to other people around her and to improve
her health condition. We should focus first to her bad habits such us stressful
lifestyle, poor diet, and smoking habit. As of now she should take a leave in her
work as a secretary and have an excuse letter with her medical record in her school
to prevent the possible transmission of the disease. Poor diet must be avoided
because it is one of the major factors that affects our immunity to fight back with
bacteria and other symptoms of it thus eating healthy foods and not skipping meals
are advisable. Lastly, her smoking habits, she must have discipline her self to avoid
smoking because if her condition gets worst life-threatening situation may occur
and permanent lung damage.
In preventing the transmission of the bacteria, make sure that family, friends
and the people you work with should be tested, avoid close contact with others until
you healthcare provider says it is ok and keep your hands clean especially when
you use it to cover your mouth. When you cough or sneeze you should cover your
mouth and nose with a tissue, put your used tissue in a closed bag and throw it
away properly, if you don’t have tissue, cough and sneeze to your upper sleeves or
elbow, not your hands and you can use alcohol to sanitized your hand or wash your
hands for about 20 seconds in warm water. Wearing N95 mask or other mask is
advisable if you really need to interact with other people to prevent the
transmission. Lastly, if you feel something serious again about her health regarding
to her condition don’t hesitate to be admitted here in the hospital and continue
taking the medication that the doctor gave to you.
Jessa was instructed to wear mask but she repeatedly pulls it off and you find
it lying in the sheets. How will you address this concern?
The stubbornness of some patient should be expected but we should be
mindful about controlling our emotion because we might get into our boiling point.
In this case I will go and talk to her in a good manner. I will ask her what her
reasons why she keep removing her mask. After hearing her side, I will remind her
again the importance of wearing mask about the transmission to other patients that
may occur. And I will tell it to her that it wont last long until you are allowed to
remove it once you were isolated or discharge to your home.
