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16. Oxygenation

June 17, 2024

FUNDAMENTALS OF NURSING PRACTICUM

METHODICAL INSTRUCTION

FOR STUDENTS OF THE I COURSE

NURSING SCHOOL

LESSON № 16 (PRACTICAL – 6 HOURS)

Theme: Oxygenation.

Aim: To be able to perform nursing interventions according to nursing care plan and needs of the patient, to learn how properly evaluate the quality of care and outcomes for the patient.

Professional orientation of students:

Oxygenation is required to sustain life. The cardiac and respiratory systems function to supply the body’s oxygen demands. Blood is oxygenated through the mechanisms of ventilation, perfusion, and transport of respiratory gases. Neural and chemical regulators control the rate and depth of respiration in response to changing tissue oxygen demands. Human can live without oxygeot more than 6 minutes, that is why it is important for nurses to know the mechanism of oxygenation and manage the all problems connected with it.

Methodology of Practical Class: 9:00-12:00

Algorithm of students’ communication with patients with pathology in subject (communication skills)

During examination of the patient students have to use such communicative algorithm.

Complaints and anamnesis taking in patients.

1. Friendly facial expression and smile.

2. Gentle tone of speech.

3. Greeting and introducing.

4. Take complaints and anamnesis in a patient.

5. Explain to the patient results of his/her lab tests correctly and accessibly.

6. Explain to the patient your actions concerning him/her (the necessity of hospitalization, certain examinations and manipulations), which are planned in future.

7. Conversation accomplishment.

Objective examination:

Physical methods of examination of patients with internal diseases

1. Friendly facial expression and smile.

2. Gentle tone of speech.

3. Greeting and introducing.

4. Explain to a patient, what examinations will be carried out and get his/her informed consent.

5. Find a contact with the patient and make an attempt to gain his/her trust.

6. Inform about the possibility of appearing of unpleasant feelings during the examination.

7. Prepare for the examination (clean warm hands, cut nails, warm phonendoscope, etc.).

8. Examination (demonstration of clinical skill).

9. Explain to the patient results of his/her lab tests correctly and accessibly.

10. Conversation accomplishment.

Estimation of laboratory and instrumental investigations

Informing about the results of examination of patients with internal diseases

1. Friendly facial expression and smile.

2. Gentle tone of speech.

3. Greeting and introducing.

4. Explain to a patient results of his/her lab tests correctly and clearly.

5. Involve the patient into the conversation (compare present examination results with previous ones, clarify whether your explanations are clearly understood).

Planning and prognosis the results of the conservative treatment

Friendly facial expression and smile.

1. Gentle tone of speech.

2. Greeting and introducing.

3. Correct and clear explanation of necessary treatment directions.

4. Discuss with a patient the peculiarities of taking medicines, duration of their usage, possible side effects; find out whether your explanations are clear for him/her or not.

5. Conversation accomplishment.

Work 1.

Master the next practical skills

Practical Skill Administering Oxygen Therapy

Practical Skill Assisting a Client with Controlled Coughing and Deep

Practical Skill Administering Pulse Oximetry

Practical Skill Removing a Chest Tube

Practical Skill Maintaining and Cleaning the Tracheostomy Tube

Work 2. Write a NCP for the following situational task please.

Haydon Calloway is a 67-year-old client with emphysema. The home health nurse is responsible for teaching him about oxygen, his medications, and helping him learn to cope with his emphysema at home. Mr. Calloway has a cough and becomes short of breath with mild activity (walking 10 steps). He would like to improve his activity tolerance so he can participate in activities at the senior citizen’s center. He has oxygen on at 2 Liters per minute via nasal cannula. His history reveals that he has smoked two packs of cigarettes a day for over 40 years.

Work 3:

Review following video links:

Coughing and Deep Breathing Instructional Video

http://www.youtube.com/watch?v=tu2mOvvb6dk&feature=related

Tracheostomy Care

http://www.youtube.com/watch?v=Wimw7bz0fLo

Oxygen Therapy 1,2,3,4 Parts.

http://www.youtube.com/watch?v=Bw3p6tyy6S8

Oxygen Therapy Skills Demonstration (1 of 2)

1 Part http://www.youtube.com/watch?v=wP1_CqcEV5Y&feature=related

2 Part http://www.youtube.com/watch?v=4BnPy9ppSHw&feature=related

Seminar discussion of theoretical issues: 12:30-14:00

Students discussion related to the written NCP.

Individual Students Program

Test evaluation and situational tasks. 14:15-15:00

Initial level of knowledge and skills are checked by solving situational tasks for each topic, answers in test evaluations and constructive questions.

(the instructor has tests & situational tasks)

1. The first step in the process of oxygenation is

ventilation

oxygen transport in the blood

alveolar gas exchange

circulation

2. Which of the following does not stimulate ventilation?

increase in the concentration of hydrogen ions in the blood

increase in the concentration of carbon dioxide in the blood

decrease in blood oxygen concentration

increase in concentration of bicarbonate ions in the blood

3. What condition may cause a shift to the left of the oxyhemoglobin dissociation curve resulting in less oxygen being available to the tissues?

massive transfusions of banked blood

acidosis

hyperthermia

hypoxia

4. The heartbeat normally originates in which part of the heart?

Purkinje fibers

SA node

AV node

bundle of His

5. Which condition is a restrictive pulmonary disease?

asthma

chronic bronchitis

emphysema

pneumonia

6. A collection of fluid between the pleural layers is called a

pleural effusion

pneumothorax

hemothorax

tension pneumothorax

7. Heart failure is a condition in which the heart

stops beating

is unable to pump enough blood to meet the metabolic needs of the body

beats very slowly

beats very rapidly

8. The utilization of glucose for cellular energy is known as which type of metabolism?

anaerobic

stable

aerobic

unstable

9. When tissue or organs are destroyed as a result of oxygen deprivation, it is known as

an infarction

ischemia

hypoxia

dead space

10. During assessment of the client with pneumonia, the nurse notes a bluish coloration of the skin. The nurse interprets this to mean the client is

in the early stages of a respiratory problem

improving

hypoxic

hyperventilating

Student should know:

1. The structure and function of the respiratory system.

The structure and function of the cardiovascular system.
The processes of breathing (ventilation) and gas exchange (respiration).
Factors influencing respiration and circulatory function.
Common signs of impaired respiratory function.

Student should be able to:

Identify and describe nursing measures to promote cardiorespiratory function and oxygenation.
Explain the use of therapeutic measures such as artificial airways, medications, oxygen therapy, inhalation therapy, pharyngeal suction, and chest drainage to promote cardiorespiratory function.

Correct answers of test evaluations and situational tasks:

1. ANS: A

2. ANS: D

3. ANS: A

4. ANS: C

5. ANS: D

6. ANS: A

7. ANS: B

8. ANS: B

9. ANS: A

10. ANS: C

References: