Hypoxemia, Hypoxia & Techniques to Improve Oxygenation - Fundamentals of Nursing |@LevelUpRN
Summary
TLDRIn this educational video, Meris discusses hypoxemia and hypoxia, detailing the importance of arterial blood gas tests for diagnosis and the distinction between low blood oxygen and tissue oxygen deficiency. She emphasizes early and late signs of oxygen deprivation and the risk of oxygen toxicity, especially in patients on high oxygen therapy. Meris also highlights various techniques to improve oxygenation, such as deep breathing, coughing exercises, and incentive spirometry, stressing their significance in nursing practice and patient care.
Takeaways
- š Hypoxemia refers to low oxygen levels in the arterial blood and requires an arterial blood gas (ABG) test for diagnosis.
- š Hypoxia is the decreased availability of oxygen in the tissues and is distinct from hypoxemia, which is blood-specific.
- šØāāļø Ventilation, diffusion, and perfusion are the three key processes for gas exchange in the respiratory system.
- š Early signs of decreased oxygenation include restlessness, irritability, and anxiety, while late signs involve changes in consciousness and cyanosis.
- š”ļø Oxygen toxicity is a risk when patients receive high levels of supplemental oxygen, such as 100% oxygen therapy.
- š To prevent oxygen toxicity, use the lowest effective flow rate of oxygen for patients.
- š§ High Fowler's position is beneficial for oxygenation in conscious patients, while prone positioning can help in severe cases like ARDS.
- šļøāāļø Techniques to improve oxygenation include deep breathing, coughing, positioning, and the use of incentive spirometry.
- š Educating patients on the importance of deep breathing and coughing exercises can help prevent atelectasis and improve blood flow.
- š Incentive spirometry involves controlled deep breathing exercises using a device to expand the lungs and should be done frequently.
- šŗ Patients are encouraged to use incentive spirometry regularly, such as during commercial breaks while watching TV.
Q & A
What is the main topic of the video?
-The main topic of the video is hypoxemia, hypoxia, and techniques to improve oxygenation in the context of nursing practice.
What are the three key processes in the respiratory system mentioned in the script?
-The three key processes mentioned are ventilation, diffusion, and perfusion.
What does hypoxemia specifically refer to?
-Hypoxemia refers to low oxygen levels specifically in the arterial blood, and it requires an arterial blood gas (ABG) test for diagnosis.
How is hypoxia different from hypoxemia?
-Hypoxia refers to decreased oxygen in the tissues, which is a condition of oxygen deficiency at the tissue level, whereas hypoxemia is specifically about low oxygen levels in the arterial blood.
What are the early signs of decreased oxygenation mentioned in the script?
-The early signs of decreased oxygenation include restlessness, irritability, and anxiety.
What is the importance of using the lowest flow rate of oxygen for patients?
-Using the lowest flow rate of oxygen is important to avoid putting patients at risk for oxygen toxicity, which can occur when they receive above-normal percentages of oxygen.
What is the best position to improve oxygenation in a conscious patient according to the script?
-The High Fowler's position is the best to improve oxygenation in a conscious patient.
What is prone positioning useful for in patients with severe respiratory conditions?
-Prone positioning can be useful in inflating the posterior lower lobes of the lung in patients with severe conditions like ARDS.
What is the purpose of deep breathing and coughing exercises for patients?
-Deep breathing and coughing exercises are used to prevent atelectasis by inflating the alveoli and to promote blood flow from the extremities back to the heart to prevent DVT.
What is an incentive spirometer and how is it used?
-An incentive spirometer is a device that helps to inflate the lungs through controlled deep-breathing exercises. Patients are instructed to breathe in, not blow, and use it about 10 times an hour while awake.
What is the next topic to be covered in the video series?
-The next topic in the video series will be on oxygen delivery devices, oxygenation interventions, and suctioning.
Outlines
š Understanding Ventilation, Diffusion, and Perfusion
In the first paragraph, Meris introduces the video's focus on hypoxemia, hypoxia, and oxygenation techniques, referencing the Fundamentals of Nursing flashcards available on leveluprn.com. She begins with a review of key respiratory terms: ventilation, which is the movement of air in and out of the lungs; diffusion, the gas exchange between alveoli and capillaries; and perfusion, the gas exchange between blood and tissues. Meris emphasizes the importance of arterial blood gas (ABG) for diagnosing hypoxemia and distinguishes hypoxemia, characterized by low oxygen in arterial blood, from hypoxia, which refers to decreased oxygenation at the tissue level. She outlines early and late signs of decreased oxygenation and discusses the risk of oxygen toxicity, particularly in patients receiving high levels of supplemental oxygen, advocating for the use of the lowest effective flow rate to mitigate this risk.
š Techniques to Enhance Oxygenation and Patient Education
The second paragraph delves into various techniques to improve oxygenation, such as deep breathing, coughing, positioning, and the use of incentive spirometry. Meris highlights the significance of these methods in preventing atelectasis and promoting blood circulation to prevent deep vein thrombosis (DVT). She specifically mentions the High Fowler's position as optimal for conscious patients to enhance oxygenation and notes that prone positioning can be beneficial for patients with ARDS. Meris also discusses the importance of patient education on the proper use of incentive spirometry, emphasizing the need for controlled deep breathing exercises and recommending its use about 10 times per hour while awake. She concludes by inviting viewers to engage with the content through likes, comments, and subscriptions, and teases upcoming videos on related topics.
Mindmap
Keywords
š”Hypoxemia
š”Hypoxia
š”Ventilation
š”Diffusion
š”Perfusion
š”Oxygen Toxicity
š”Incentive Spirometry
š”Deep Breathing
š”Coughing Exercises
š”Positioning
š”Atelectasis
Highlights
Introduction to the topic of hypoxemia, hypoxia, and techniques to improve oxygenation.
Explanation of fundamental respiratory terms: Ventilation, Diffusion, and Perfusion.
Definition of hypoxemia as low oxygen in arterial blood, requiring an arterial blood gas test for diagnosis.
Differentiation between hypoxemia and hypoxia, with hypoxia referring to decreased oxygen in tissues.
Importance of recognizing early and late signs of decreased oxygenation, such as restlessness and changes in consciousness.
Risk of oxygen toxicity with high levels of oxygen therapy and the need to use the lowest effective flow rate.
Techniques to improve oxygenation including deep breathing, coughing, positioning, and incentive spirometry.
The significance of High Fowler's position for improving oxygenation in conscious patients.
Prone positioning's utility in inflating the posterior lower lobes of the lung for ARDS patients.
Importance of educating patients on deep breathing and coughing exercises to prevent atelectasis.
Introduction to incentive spirometry and its role in controlled deep-breathing exercises.
Patient teaching tips for using incentive spirometry effectively, emphasizing the inhalation rather than blowing.
Recommendation for patients to use incentive spirometry 10 times an hour while awake.
Invitation to subscribe to the channel for upcoming content on oxygen delivery devices and interventions.
Encouragement for viewers to like, comment, and share the video for further engagement.
Transcripts
Hi. I'm Meris, and in this video, we'reĀ going to be talking about hypoxemia, hypoxia,Ā Ā
and techniques to improve oxygenation. I'm goingĀ to be following along with our FundamentalsĀ Ā
of Nursing flashcards. These are available onĀ our website, leveluprn.com. And if you alreadyĀ Ā
have a set of your own and you want to followĀ along with me, I'm starting on card number 130.Ā Ā
Let's get started. So first up, a quick reviewĀ of some terms. This is going to be on card 130.Ā Ā
Ventilation. Ventilation is moving air in andĀ out of the alveoli or in and out of the lungs.Ā Ā
Diffusion is the exchange of gases, carbon dioxideĀ and oxygen, from the alveoli to the capillaries,Ā Ā
the intravascular space. And perfusion is theĀ exchange of gases, carbon dioxide and oxygen,Ā Ā
between the blood and the tissues. So first, IĀ ventilate, then I diffuse, and then I perfuse.Ā
So moving on to card 131. Really important stuffĀ here. And look, there is so much red and bold textĀ Ā
here. That means this is an incredibly importantĀ card. I would say this is maybe one of the mostĀ Ā
important cards in the deck just because thisĀ is so fundamentally important to all of nursingĀ Ā
practice and so many different disorders that weĀ cover. So hypoxemia. What is hypoxemia? So hypo-,Ā Ā
meaning low, and then ox, meaning oxygen, andĀ -emia, meaning blood, so low oxygen in theĀ Ā
blood. So this means specifically in the arterialĀ blood. And key point here is that you have to haveĀ Ā
an arterial blood gas, an ABG, to diagnoseĀ hypoxemia. Definitely check out the lab valuesĀ Ā
and ABG interpretation deck for more on that. Now, hypoxia is a word that is sometimes usedĀ Ā
interchangeably in clinical practice, but it hasĀ a different meaning. It means decreased oxygenĀ Ā
in the tissues. So decreased oxygenationĀ at the tissue level. This is not good,Ā Ā
right? If we have hypoxia, generalized symptoms ofĀ oxygen deficiency, it's really, really not good.Ā Ā
We do have some early versus late signs here.Ā And I just want to point out the most importantĀ Ā
ones. Early signs of decreased oxygenationĀ are going to be restlessness, irritability,Ā Ā
or anxiety. Think about if I made you breatheĀ through a straw. Before you develop any otherĀ Ā
symptoms, you're going to panic, right? You'reĀ going to feel restless and anxious because you'reĀ Ā
not oxygenating properly. Now, late symptomsĀ would be a change in level of consciousness,Ā Ā
cyanosis, anything like that. We've goneĀ way past the early stages into late stages.Ā
Oxygen toxicity is also possible. Now,Ā I'm not going to get oxygen toxicity justĀ Ā
breathing at atmospheric pressure, normalĀ air around me, but this is going to happenĀ Ā
when I receive above-normal percentagesĀ of oxygen. So when does this happen?Ā Ā
It's mainly going to be with your patients who areĀ receiving 100% oxygen or high levels of oxygen,Ā Ā
such as with oxygen therapy or ventilation.Ā So these patients need to be-- you need toĀ Ā
be thinking about oxygen toxicity with theseĀ patients. Important key point for this is thatĀ Ā
you should use the lowest flow rate, meaningĀ the fewest number of liters per minute asĀ Ā
is clinically appropriate for your patients toĀ avoid putting them at risk for oxygen toxicity.Ā
Okay. So last card we're going to talk about - I'mĀ going to say that this goes with the other as oneĀ Ā
of the most important cards in the deck justĀ as it relates to nursing practice - techniquesĀ Ā
to improve oxygenation. I would say learnĀ it, love it, get a necklace that says it.Ā Ā
Everything on this card you've got to know, andĀ you need to know it forever. So deep breathing,Ā Ā
coughing, positioning, incentive spirometry,Ā all of those are going to be techniquesĀ Ā
to increase oxygenation. Quick question. PauseĀ it after I ask you. What is the best positionĀ Ā
to improve oxygenation in a conscious patient?Ā Pause and think about it. All right. I hope youĀ Ā
said High Fowler's. High Fowler's position, whichĀ we talked about in an earlier video, is the bestĀ Ā
to improve oxygenation in a patient who is alertĀ and oriented and otherwise doing okay. However,Ā Ā
prone positioning can be useful in inflatingĀ the posterior lower lobes of the lungĀ Ā
in a patient who's really sick with ARDS. So deepĀ breathing and coughing exercises, you want toĀ Ā
educate your patients to do those frequently. WhatĀ are we trying to prevent there? Think about it.Ā Ā
We're trying to prevent atelectasis, right? We'reĀ trying to inflate those alveoli and also use theĀ Ā
respiratory pump to get blood moving from ourĀ extremities back to the heart to prevent DVT.Ā
Incentive spirometry. We have a lot on here, so IĀ want to point it out. Incentive spirometry. That'sĀ Ā
using a device called an incentive spirometer, andĀ it's going to help to inflate the lungs throughĀ Ā
deep breathing, but it's controlled deep-breathingĀ exercises. Important patient teaching would beĀ Ā
that you breathe in. Don't blow; breathe in. SoĀ it's an incentive spirometer, so you breathe in.Ā Ā
That's our cool chicken hint there. Super-duperĀ important. And we want our patients to use thisĀ Ā
about 10 times an hour every hour that they'reĀ awake. They don't need to wake up to do this,Ā Ā
but it is important that while they areĀ awake, they be using the incentive spirometer.Ā Ā
You'll hear a lot of the time that nursesĀ will tell their patients to use it duringĀ Ā
the commercial breaks if they're watching TV. Okay. So that is it for hypoxemia, hypoxia,Ā Ā
and techniques to improve oxygenation. I hope youĀ liked it. If you did, please go ahead and likeĀ Ā
this video so that I know. If you have a greatĀ way to remember something, I want to hear it,Ā Ā
so please leave it in the comments below. AndĀ be sure to subscribe to the channel becauseĀ Ā
we have great stuff coming your way very soon.Ā The next video in this series is going to be onĀ Ā
oxygen delivery devices, oxygenationĀ interventions, and suctioning. I hope toĀ Ā
see you there. Thanks so much, and happy studying. I invite you to subscribe to our channel and shareĀ Ā
a link with your classmates and friends in nursingĀ school. If you found value in this video, be sureĀ Ā
and hit the like button, and leave a comment andĀ let us know what you found particularly helpful.
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