Oxygen Supply and Analysis
Oxygen supply and Cardiac Output
Oxygen supply is determined by the hearts ability circulate blood, oxygen content present in blood, and the capacity of blood to transport oxygen (Gillespie, 2012). Cardiac output is determined by the heart rate and stroke volume, where stroke volume is the amount of blood ejected from the heart with each contraction (Gillespie, 2012). Preload, afterload, and contractility all affect cardiac output (Gillespie, 2012).
Preload. Preload is the volume of blood in the ventricles at the end of diastole (Gillespie, 2012). Total circulating volume, venous blood return, and ventricular compliance affect preload (Gillespie, 2012). Patient 1 has a decreased preload as he is bleeding profusely
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SaO2 reflects arterial oxygen saturation which is determined by the concentration of oxygen inspired, capacity to ventilate, and effectiveness of alveolar gas exchange (Gillespie, 2012). Normal Sa02 range is 95-100%. His SaO2 is 88% on RA which would indicate that the concentration of oxygen is low. We do not have enough much information so it is difficult to say what other factors may be affecting his arterial oxygen saturation and …show more content…
The movement of air into and out of lungs is known as ventilation (Gillespie, 2012). Factors that impact ventilation include muscle function, lung compliance, and air way resistance (Gillespie, 2012). Secretions in the lungs decrease compliance and increase resistance (Gillespie, 2012). He has a high RR of 32 indicating that increased work of breathing and poor ventilation. We would further assess use of accessory muscle indicating an increased work of breathing, presence of secretions which would decrease lung compliance and increase resistance (Gillespie, 2012). His overall tidal volume and vital capacity should be decreased due to a high RR. Having a problem with ventilation can result in a decreases SaO2 and therefore would decreases oxygen supply to organs and tissues (Gillespie, 2012). Alveolar gas exchange. We do not have too much information therefore cannot conclude if he has a V/Q mismatch. He however he has a SaO2 of 88% and therefore we would apply supplemental oxygen to increase the driving force of oxygen. We would further assess for pneumonia, his history eg asthma, preload and cardiac output, which would all result in a V/Q
The contraction of the inspiratory muscles increases the volume of the thoracic cavity causing the pressure within the alveoli to decrease and air to flow into the alveoli. During resting inspiration, the diaphragm, the external intercostals and the parasternal intercostals contract to stimulate inspiration. During forced inspiration the scalene and the sternocleidomastoid muscles contract to further expand the thoracic cavity. The pectoralis minor muscles also play a minor role in forced inspiration. During quiet breathing, relaxation of these muscles causes the volume of the thoracic cavity to decrease, resulting in expiration. During a forced expiration, the compression of the chest cavity is increased by contraction of the internal intercostal muscles and various abdominal
R.S.’s clinical findings as a consequence of his chronic bronchitis are likely to include: being overweight, experiencing shortness of breath on exertion, producing excessive amount of sputum, having a chronic productive cough, as well as edema and hypervolemia just to name a few. (Copstead & Banasik, 548) Some of these signs and symptoms would be different if R.S. had emphysematous COPD. In emphysema (or “pink puffers”), there is weight loss, the cough is absent or negligible, and edema is not present. While central cyanosis and jugular vein distention are present in late chronic bronchitis, these pathologic manifestations are absent in emphysema. . (Copstead & Banasik, 549)
The Mayo Clinic’s book on High Blood Pressure was full of detailed facts about blood pressure and what it is. This is extremely significant to the experiment because blood pressure is one of the variables being tested. Understanding blood pressure is one of the key components to receiving accurate results from this experiment. Most of the book is on high blood pressure, which is not necessary for the experiment, but the book still had plenty of useful information about blood pressure itself. The book explains that when the heart beats, a surge of blood is released from the left ventricle. It also tells of how arteries are blood vessels that move nutrients and oxygenated blood from the heart to the body’s tissues. The aorta, or the largest artery in the heart, is connected to the left ventricle and is the main place for blood to leave the heart as the aorta branches off into many different smaller
McKenzie, D. C. (2012). Respiratory physiology: Adaptations to high-level exercise. British Journal of Sports Medicine, 46(6), 381. doi:10.1136/bjsports-2011-090824
The two measurable components in the blood pressure equation are the systolic and diastolic pressures. They are writt...
Vitals signs: BP 90/60, HR(heart rate) 90-100, RR(respiratory rate) 22, Temp: 100.2 F, Oxygen Saturation: 98%
First, is the inability of the heart to maintain adequate cardiac output to support full functions; and second, is the recruitment of implements planned to maintain the cardiac reserve. Preload represents the stiffing that exists in the walls of the heart as an outcome of diastolic filling. Afterload represents the force to contract the heart, which must produce to eject blood from the filled atriums. Contractility is the ability of the contractile fundamentals of the heart muscle to interact and shorten against a load. Overall cardiac output is the amount of blood that the heart pumps each minute.
An Arterial Blood Gas Analysis (ABGA) measures the oxygen saturation and carbon dioxide concentrations in blood, which indicates, how efficiently the lungs are distributing the carbon dioxide and oxygen to and from blood. (Medical Dictionary. 2003). It is an invasive machine that takes a small sample of blood from an artery and measures the oxygen levels using two electrodes; these electrodes produce an electric current after the oxygen has flown between them and through a membrane. The current produced is proportional to the volume of oxygen in the blood. However it is the pH levels of blood that measures the carbon dioxide concentrations.
resistance from the blood vessels and vessel walls. This resistance results in an increase in cardiac afterload.
Shoemark, A., Ozerovitch, L. and Wilson, R. 2007. Aetiology in adult patients with bronchiectasis. Epub, 101 (6), pp. 1163-70.
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
My patient is male, age 49 and was admitted because of pneumonia. Pneumonia is an infection that inflames the air sacs in one or both lungs (Ross - Kerr, 2014).
During each heartbeat, the heart muscle contracts to push blood around the body. When the left ventricle contracts blood is forced into the aorta and its branches become under pressure. This pressure provides the driving force that makes blood flow through arteries. There are two type of pressure. Systolic blood pressure is the blood pressure when the heart is contracting; normal rate of systolic blood pressure is about 120 mmHg. Diastolic blood pressure is the blood pressure when the heart is relaxing; normal rate of diastolic pressure is about 80 mmHg (Smith, 2003). In addition, the walls of the arteries contain muscle and elastic fibers. Each time that the heart beats and discharges blood into the arterial system, these fibers stretch to accommoda...
Inspiration and expiration are defined as the inhalation and exhalation of air into the lungs (Oxford University Press, 2010). The diaphragm is the key muscle in respiration. Its dome-shaped skeletal muscle separates the thoracic and abdominal cavities, consisting of muscle fibres and tendons. The fibres run upwards from their origin at the inner part of the thoracic cage and then arc towards the midline. During ordinary, quiet respiration, the diaphragm contracts and moves downward in inspiration and the diaphragmatic parietal pleura descends. Drawing down the visceral pleura so that the airways and alveoli expand and air is forced in. The diaphragm then relaxes in expiration and the recoil of the elastic tissues in the lung ejects air from the alveoli and airways. Movement of the ribcage also contributes to respiration by increasing the diameter of the chest, thus increasing the thoracic capacity and creating a lower pressure in the lungs allowing air to be sucked in. The joints between the posterior ends of the ribs and the transverse processes of the vertebrae enable a pivoting motion of the ribs upwards and outwards to increase the lateral diameter of the chest, while the anterior ends of the ribs move up and out to increase the anteroposterior diameter. The diaphragmatic movement provides approximately 75% and movement of the ribcage contributes 25% to the expansion in thoracic volume (Naish, Revest, & Syndercombe, 2009).
A reduction or lack of oxygen and/or buildup of waste leads to demise. For this reason, gas exchange is critical. Gas exchange is compromised when there is impairment of ventilation, altered transport of oxygen, or inadequate perfusion. Impaired ventilation may occur in conditions such as inadequate muscle or nerve function to move air into the lungs, such as cervical spinal cord injury; narrowed airways from bronchoconstriction like in asthma, or from obstruction like in chronic bronchitis; poor gas diffusion in the alveoli, such as pulmonary edema, acute respiratory distress syndrome or pneumonia. Altered transport of oxygen occurs when sufficient red blood cell are not available to carry oxygen, like in anemia. Inadequate perfusion develops when cardiac output is reduced, like in myocardial infarction (Giddens page 164). Asthma, chronic obstructive pulmonary disease (COPD), pneumonia, aspiration, respiratory syncytial virus (RSV), bronchiolitis, croup, tracheal esophageal fistula are the exemplars of gas