Hypoxemia, Hypoxia & Techniques to Improve Oxygenation - Fundamentals of Nursing |@LevelUpRN

Summary

In 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

• 😀 Hypoxemia refers to low oxygen levels in the arterial blood and requires an arterial blood gas (ABG) test for diagnosis.
• 😎 Hypoxia is the decreased availability of oxygen in the tissues and is distinct from hypoxemia, which is blood-specific.
• 👨‍⚕️ Ventilation, diffusion, and perfusion are the three key processes for gas exchange in the respiratory system.
• 🔍 Early signs of decreased oxygenation include restlessness, irritability, and anxiety, while late signs involve changes in consciousness and cyanosis.
• 🌡️ Oxygen toxicity is a risk when patients receive high levels of supplemental oxygen, such as 100% oxygen therapy.
• 💊 To prevent oxygen toxicity, use the lowest effective flow rate of oxygen for patients.
• 🧘 High Fowler's position is beneficial for oxygenation in conscious patients, while prone positioning can help in severe cases like ARDS.
• 🏋️‍♀️ Techniques to improve oxygenation include deep breathing, coughing, positioning, and the use of incentive spirometry.
• 📚 Educating patients on the importance of deep breathing and coughing exercises can help prevent atelectasis and improve blood flow.
• 📈 Incentive spirometry involves controlled deep breathing exercises using a device to expand the lungs and should be done frequently.
• 📺 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

00:00

😀 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.

05:02

😉 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.

Keywords

💡Hypoxemia

Hypoxemia is defined as a low level of oxygen in the arterial blood. It is a critical condition that requires diagnosis through an arterial blood gas (ABG) test. In the context of the video, hypoxemia is a key concept as it directly relates to the body's ability to oxygenate tissues properly. The script emphasizes the importance of recognizing hypoxemia through lab values, which is fundamental to nursing practice and patient care.

💡Hypoxia

Hypoxia refers to a deficiency of oxygen in the tissues, which can lead to generalized symptoms of oxygen deprivation. The video script distinguishes hypoxia from hypoxemia, noting that while the former is about tissue oxygen levels, the latter specifically pertains to arterial blood oxygen levels. Hypoxia is a central theme in the video as it represents the broader physiological impact of insufficient oxygenation.

💡Ventilation

Ventilation is the process of moving air in and out of the lungs or alveoli. It is the first step in the gas exchange process highlighted in the script. Ventilation is essential for oxygen to reach the alveoli where it can then diffuse into the bloodstream. The video script uses the term to explain the basic physiological process that precedes diffusion and perfusion.

💡Diffusion

Diffusion in the context of the video refers to the exchange of gases, specifically carbon dioxide and oxygen, between the alveoli and the capillaries. It is a passive process driven by the concentration gradient of these gases. The script mentions diffusion as a vital concept in understanding how oxygen moves from the lungs into the bloodstream.

💡Perfusion

Perfusion is the exchange of gases between the blood and the tissues. It is the final step in the sequence of gas exchange processes described in the script. Perfusion ensures that oxygen reaches the body's tissues, which is crucial for cellular respiration and energy production. The video emphasizes the importance of perfusion in maintaining adequate oxygenation at the tissue level.

💡Oxygen Toxicity

Oxygen toxicity is a potential risk when patients receive above-normal percentages of oxygen, such as during oxygen therapy or ventilation. The video script warns of this risk and advises using the lowest flow rate necessary to avoid it. This concept is important as it highlights the need for careful management of oxygen therapy to prevent adverse effects.

💡Incentive Spirometry

Incentive spirometry is a technique that involves the use of a device to encourage deep, controlled breathing exercises. The video script describes it as a method to improve lung inflation and prevent complications like atelectasis. It is a key technique discussed in the video for enhancing oxygenation and is recommended for use by patients every hour they are awake.

💡Deep Breathing

Deep breathing is a technique to increase lung volume and improve oxygenation. The video script suggests that deep breathing exercises can help prevent atelectasis by inflating alveoli and promoting blood flow. It is presented as a simple yet effective method for patients to improve their respiratory function.

💡Coughing Exercises

Coughing exercises are recommended in the script as a way to clear secretions from the respiratory tract and improve lung function. These exercises are part of the patient education to prevent atelectasis and maintain respiratory health. The video emphasizes the importance of instructing patients on the proper technique for coughing.

💡Positioning

Positioning refers to the strategic placement of a patient's body to optimize respiratory function. The video script mentions High Fowler's position as the best for conscious patients to improve oxygenation, while prone positioning is useful for patients with severe conditions like ARDS. Positioning is a practical aspect of respiratory care discussed in the video.

💡Atelectasis

Atelectasis is a condition where a part of the lung collapses or does not inflate properly, leading to reduced oxygenation. The video script discusses deep breathing, coughing, and incentive spirometry as preventative measures against atelectasis. It is an important concept as it represents a common complication that healthcare providers aim to avoid.

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're  going to be talking about hypoxemia, hypoxia,  

and techniques to improve oxygenation. I'm going  to be following along with our Fundamentals  

of Nursing flashcards. These are available on  our website, leveluprn.com. And if you already  

have a set of your own and you want to follow  along with me, I'm starting on card number 130.  

Let's get started. So first up, a quick review  of some terms. This is going to be on card 130.  

Ventilation. Ventilation is moving air in and  out of the alveoli or in and out of the lungs.  

Diffusion is the exchange of gases, carbon dioxide  and oxygen, from the alveoli to the capillaries,  

the intravascular space. And perfusion is the  exchange of gases, carbon dioxide and oxygen,  

between the blood and the tissues. So first, I  ventilate, then I diffuse, and then I perfuse. 

So moving on to card 131. Really important stuff  here. And look, there is so much red and bold text  

here. That means this is an incredibly important  card. I would say this is maybe one of the most  

important cards in the deck just because this  is so fundamentally important to all of nursing  

practice and so many different disorders that we  cover. So hypoxemia. What is hypoxemia? So hypo-,  

meaning low, and then ox, meaning oxygen, and  -emia, meaning blood, so low oxygen in the  

blood. So this means specifically in the arterial  blood. And key point here is that you have to have  

an arterial blood gas, an ABG, to diagnose  hypoxemia. Definitely check out the lab values  

and ABG interpretation deck for more on that. Now, hypoxia is a word that is sometimes used  

interchangeably in clinical practice, but it has  a different meaning. It means decreased oxygen  

in the tissues. So decreased oxygenation  at the tissue level. This is not good,  

right? If we have hypoxia, generalized symptoms of  oxygen deficiency, it's really, really not good.  

We do have some early versus late signs here.  And I just want to point out the most important  

ones. Early signs of decreased oxygenation  are going to be restlessness, irritability,  

or anxiety. Think about if I made you breathe  through a straw. Before you develop any other  

symptoms, you're going to panic, right? You're  going to feel restless and anxious because you're  

not oxygenating properly. Now, late symptoms  would be a change in level of consciousness,  

cyanosis, anything like that. We've gone  way past the early stages into late stages. 

Oxygen toxicity is also possible. Now,  I'm not going to get oxygen toxicity just  

breathing at atmospheric pressure, normal  air around me, but this is going to happen  

when I receive above-normal percentages  of oxygen. So when does this happen?  

It's mainly going to be with your patients who are  receiving 100% oxygen or high levels of oxygen,  

such as with oxygen therapy or ventilation.  So these patients need to be-- you need to  

be thinking about oxygen toxicity with these  patients. Important key point for this is that  

you should use the lowest flow rate, meaning  the fewest number of liters per minute as  

is clinically appropriate for your patients to  avoid putting them at risk for oxygen toxicity. 

Okay. So last card we're going to talk about - I'm  going to say that this goes with the other as one  

of the most important cards in the deck just  as it relates to nursing practice - techniques  

to improve oxygenation. I would say learn  it, love it, get a necklace that says it.  

Everything on this card you've got to know, and  you need to know it forever. So deep breathing,  

coughing, positioning, incentive spirometry,  all of those are going to be techniques  

to increase oxygenation. Quick question. Pause  it after I ask you. What is the best position  

to improve oxygenation in a conscious patient?  Pause and think about it. All right. I hope you  

said High Fowler's. High Fowler's position, which  we talked about in an earlier video, is the best  

to improve oxygenation in a patient who is alert  and oriented and otherwise doing okay. However,  

prone positioning can be useful in inflating  the posterior lower lobes of the lung  

in a patient who's really sick with ARDS. So deep  breathing and coughing exercises, you want to  

educate your patients to do those frequently. What  are we trying to prevent there? Think about it.  

We're trying to prevent atelectasis, right? We're  trying to inflate those alveoli and also use the  

respiratory pump to get blood moving from our  extremities back to the heart to prevent DVT. 

Incentive spirometry. We have a lot on here, so I  want to point it out. Incentive spirometry. That's  

using a device called an incentive spirometer, and  it's going to help to inflate the lungs through  

deep breathing, but it's controlled deep-breathing  exercises. Important patient teaching would be  

that you breathe in. Don't blow; breathe in. So  it's an incentive spirometer, so you breathe in.  

That's our cool chicken hint there. Super-duper  important. And we want our patients to use this  

about 10 times an hour every hour that they're  awake. They don't need to wake up to do this,  

but it is important that while they are  awake, they be using the incentive spirometer.  

You'll hear a lot of the time that nurses  will tell their patients to use it during  

the commercial breaks if they're watching TV. Okay. So that is it for hypoxemia, hypoxia,  

and techniques to improve oxygenation. I hope you  liked it. If you did, please go ahead and like  

this video so that I know. If you have a great  way to remember something, I want to hear it,  

so please leave it in the comments below. And  be sure to subscribe to the channel because  

we have great stuff coming your way very soon.  The next video in this series is going to be on  

oxygen delivery devices, oxygenation  interventions, and suctioning. I hope to  

see you there. Thanks so much, and happy studying. I invite you to subscribe to our channel and share  

a link with your classmates and friends in nursing  school. If you found value in this video, be sure  

and hit the like button, and leave a comment and  let us know what you found particularly helpful.