VCBC gas exchange Concept Notebook 2021 PDF

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Lecture notes about concept of clotting. we learned about this topic during class today and is very helful. You can see all the topics...

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Concept Notebook Name: Cinthya Ferradaz Course: 346 Faculty Facilitator: Profesor Lorenzo

Concept: Gas Exchange Activity: VCBC Date/Time:2/11/2021

If you did a notebook for this concept in a previous term, you should add to the content, but you will need to date all new content and expand, using different color and/or font. Submitting the same notebook without noting the changes is considered plagiarism. ANY plagiarism issues noted will result in a 0 grade. The assignment will need to be redone for the ability to pass the course, but your score will remain a 0.

Example: Gas Exchange BSN205; Gas Exchange BSN246, Gas Exchange BSN366 This will also serve as a study aide for you as you continue through the program, study for the HESI and NCLEX exams. Your reference should be your course textbooks available via the course link, so please site per APA guidelines. Do NOT copy and paste, it must all be in your own words. Client (virtual or living) background: Please tell us a little about the client you cared for today, either virtual or living, just one sentence telling us about them. For living clients, no personal identifying information needed. Pt was having issues breathing. Pt was showing signs & symptoms of Impaired gas exchange. Respiratory alkalosis, very anxious. Related concepts (explain): Related exemplars: Acid Base- respiratory system contributes to the balance of acid and base in the body by -Asthma regulating blood levels and carbonic acid . - Cystic fibrosis -Pleural effusion Mobility- reduce when pt with impaired gas -RSV exchange becomes dyspneic when walking or -Aplastic Anemia climbing stairs(Giddems,2017) - Thalassemia -Pneumothorax Perfusion- when ventilation is insufficient, the pressure oxygen in the alveoli drops. Anxiety- pt that is unable to get sufficient oxygen become very anxious (Giddems,2017) Nutrition- adequate nutrition is important. Pt with impaired gas exchange expend more energy while they are eating, so they require more calories, and proteins, and small portions so they don’t get tired while eating (Giddems,2017) Fatigue- pt that uses accessory muscles and has to work hard to breath, use a lot of amount of energy and that contributes to pt

fatigue (Giddems,2017)

Related Assessments (explain):

Related Lab & Diagnostic Test (explain): Assess respiratory rate,effort, Chest rays to see the cause or and use of accessory factor of the impaired gas muscle.Rapid and shallow exchange. breathing affects gas exchange. Increased respiratory rate, ABG to check for respiratory abdominal breathing, and nasal alkalosis and acidosis. flaring are a sing of hypoxia. Respiratory acidosis indicate hypoventilation, and alkalosis Assess the lungs. The presence indicate hyperventilation. of crackles and wheezes are a sing of airway obstruction and Sputum examination to help with that can lead to hypoxia. the diagnose of the respiratory Diminished breath sounds are a disorder(Giddems,2017). sing of poor . Gas The sweat chloride test to screen ventilation(Impaired exchange,2016). the pt for cystic fibrosis(Giddems,2017). Monitor BP and HR. They will increase with hypercapnia and Ventilation-perfusion scan to hypoxia but if both conditions diagnose disorders involving become severe, the BP and HR perfusion and will decrease and pt will show ventilation(Giddems,2017). sing of dysrhythmia. Positron emission tomography to Monitor patient nutritional distinguish benign from status. Malnourished patients malignant pulmonary have a reduced respiratory nodules(Giddems,2017). mass, affecting muscle function. Pulmonary function studies to assess the presence and severity Monitor Pt hydration status. of diseases in large/small airways Overhydration can impaired (Giddems,2017). gas exchange in pt with a heart condition such as heart failure, and dehydration can reduce the ability to to clear secretions in patients with COPD(Impaired Gas exchange,2016).

Related Nursing Interventions (explain): Position Pt in semi fowlers. This position will help to increase lung expansion and full descent of the diaphragm.

Encourage/ assist the patient with ambulation is permitted/ physician’s order. Ambulations will facilities pt lung expansion. Administrated oxygen as prescribed to maintain PaO2 at an acceptable level. Encourage the patient to deep breaths and cough 2/3 times to increase sputum clearance. Encourage the use of an incentive spirometer to prevent atelectasis. Paces activities to prevent fatigue. Activities will increase the use of oxygen so they should be planned so the pt don’t become hypoxic. Educate the family about complications of the disease( RSV, cystic

.

fibrosis, and the importance to adhere to the medication regimen to avoid further complications.

Monitor PT behavior and mental status. Changes in mental status can be a sign of impaired gas exchange. Monitor for signs & symptoms of atelectasis ( crackles, diminished chest excursion, bronchial breath sound). If alveoli collapse,perfusion will increase without ventilations leading to hypoxemia(Impaired Gas exchange,2016). .

Related Medications (explain):

Potential Complications (explain): Antimicrobials to kill/limited Pneumothorax. This can growth of be complete or partial and occurs when air microorganisms(Giddems,2017). leaks into the space between the lung and Bronchodilator to dilates the chest wall. Shortness of bronchi. breath is one of the signs.Untreated Anthistamines to relieve pneumothorax can lead symptoms of to pt death. rhinorrhea(Giddems,2017). Glucocorticoids reduce bronchial hyperreactivity that occurs for example asthma by suppressing inflammation (Giddems,2017). Mucolytics to make the mucus more liquid. That will increase the flow of respiratory tract secreations(Giddems,2017). Anticholinergisc to improve lung functions (Giddems,2017). Decongestants to relieve

Shock. In sepstic shock tissue perfusion decrease leading to organs failures such as kidney, liver and lungs. Aneurysm. This occurs where is a weak spot in a brain blood vessel that fills with blood and bulges out. Left untreated, the aneurysm can rupture and pt can

Collaborative Care (explain): Nutritionist. Adequate nutrition is needed to provide energy for the increased work of breathing (Giddems,2017). Respiratory Therapy. Patients with impaired gas exchange may need airway support (Giddems,2017). Pulmonologist. This doctor can treat many breathing related conditions such as cystic fibrosis, pulmonary fibrosis, lung cancer, COPD etc.

congestion in passageways and sinus (Giddems,2017).

suffer a severe stroke. Anemia.A decrease in RBC transporting oxygen and CD impairs the body’s ability for gas exchange. Sickle cell anemia tends to stick together blocking small blood vessel leading to hypoxemia,alveolar dead space, and the ability of Hgb in RBC to carry oxygen. Pulmonary Emboli. Emboli obstruct perfusion of alveoli (Giddems,2017). Pulmonary contusion can occur as a result of chest trauma that damages the structure and function of the lung. This type of injury leads to reduce gas exchange and can be a life threatening(Molnár, 2019).

References: Giddens, J. F(2017) Concepts for Nursing Practice, 2nd Edition. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9780323374736/

Impaired Gas exchange. (2016). Retrieved from http://nursinginterventionsrationales.blogspot.com/2013/08/impaired-gas-exchange_3.html

Molnár, T. (2019, February). Pulmonary contusion. Retrieved February 13, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389561/...