Hypoxemia, Hypoxia & Techniques to Improve Oxygenation

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 by 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. An 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 the 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. Incentive spirometer frequently to prevent atelectasis and improve respiratory function. Additionally, deep breathing and coughing exercises are also recommended to help prevent complications such as deep vein thrombosis (DVT) by promoting blood flow from the extremities back to the heart. Therefore, educating patients on the importance of regularly performing these exercises is vital. 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.