HYPOXIA

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HYPOXIA & ISCHEMIA:

HYPOXIA & ISCHEMIA PRESENTED BY : KIRAN RANDHAWA

INTRODUCTION :

INTRODUCTION HYPOXIA LITERALLY MEANS “ DEFICIENT IN OXYGEN ” . IT CAN REFER TO,A SHORTAGE OF OXYGEN DUE TO SOME OF THE CONDITIONS LIKE HIGH ALTITUDE.

DEFINITION:

DEFINITION HYPOXIA IS A PATHOLOGICAL CONDITION IN WHICH THE BODY AS A WHOLE OR REGION OF BODY IS DEPRIVED OF ADEQUATE OXYGEN SUPPLY .

CAUSES:

CAUSES HIGH ALTITUDE . DECREASED OXYGEN SUPPLY TO AN AREA . DECREASED HAEMOGLOBIN LEVEL LOWER OXYGEN CARRYING CAPACITY . POOR TISSUE PERFUSION . IMPAIRED VENTILLATION . DECREASED DIFFUSION OF OXYGEN

CLINICAL MANIFESTATIONS:

CLINICAL MANIFESTATIONS SHORTNESS OF BREATH RESTLESSNES HEADACHE DECREASED CONCENTRATION NAUSEA FATIGUE APPREHENSION . ALTERED LEVEL OF CONSCIOUNESS COMA DEATH

TYPES:

TYPES HYPOXEMIC HYPOXIA CIRCULATORY HYPOXIA ANEMIC HYPOXIA HISTOTOXIC HYPOXIA

HYPOXEMIC HYPOXIA:

HYPOXEMIC HYPOXIA CAUSE: AS A RESULT OF LOW PARTIAL PRESSURE OF OXYGEN IN ARTERIAL BLOOD . AS IN HIGH ALTITUDE ADDITION OF NOXIOUS GASES AS NITROUS OXIDE ,CARBON MONOXIDE . SLEEP APNEA . INADEQUATE PULMONARY VENTILLATION. CAUSE DECREASE IN OXYGEN CON CENTRATION OF BLOOD LEADS TO HYPOXIA

CIRCULATORY HYPOXIA:

CIRCULATORY HYPOXIA CAUSES : AS A RESULT FROM IN ADEQUATE CAPILLARY CIRCULATION. VASCULAR OBSTRUCTION . SHOCK DECREASED BLOOD SUPPLY TO THE AREA OXYGEN CONCENTRATION OF THAT PART DECREASED . LEADS TO HYPOXIA

ANEMIC HYPOXIA:

ANEMIC HYPOXIA CAUSES : DECREASED EFFECTIVE CONCENTRATION OF HAEMOGLOBIN IN BLOOD ANAEMIA BLEEDING LEUKEMIA DECREASED DISSOLVED OXYGEN IN BLOOD . CAUSE HYPOXIA

HISTOTOXIC HYPOXIA:

HISTOTOXIC HYPOXIA CAUSE : TOXIC SUBSTANCE IN THE OXYGEN CONC. TISSUE . ACIDOSIS THE QUANTITY OF OXYGEN REACHING TO THE CELL IS NORMAL. ORGANS ARE NOT ABLE TO UTILISE THE OXYGEN HYPOXIA

MEDICAL MANAGEMENT:

MEDICAL MANAGEMENT CONTROL OF PRIMARY DISEASES MAINTENANCE OF PATENT AIRWAY OXYGEN THERAPY TREATMENT OF ACIDOSIS

NURSING RESPONSIBILITY:

NURSING RESPONSIBILITY MONITOR FOR & PREVENT RESPIRATORY DEPRESSION . CHECK RESPIRATORY RATE . CHECK BLOOD PRESSURE READING CHECK FOR CYANOSIS USE INCENTIVE SPIROMETRY. OBTAIN PULSE OXIMETRY READING

CONTINUED …:

CONTINUED … ADMINISTER BLOOD IF HYPOXIA DUE TO ANEMIA . ENCOURAGE COUGHING & DEEP BREATHING EXERCISE . MAINTAIN ADEQUATE HYDRATION . RAISE SIDE RAILS IF DROWSINESS OCCUR.

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ISCHEMIA

ISCHEMIA:

ISCHEMIA IT IS A CONDITION WHICH OCCURS DUE TO A DEFICIENT BLOOD SUPPLY TO ANY PART OF THE BODY LEADS TO CERTAIN IRREVERSIBLE CHANGES IN THE BODY .

DEFINITION:

DEFINITION IT IS DEFINED AS A CONDITION IN WHICH THERE IS INADEQUATE BLOOD SUPPLY TO MEET THE METABOLIC DEMANDS OF A TISSUE.

CAUSES:

CAUSES OBSTRUCTION OF ARTERY . HYPOTHERMIA . THROMBOSIS . DECREASED BLOOD VOLUME . BED SORES . SURGICAL PROCEDURE . VASOCONSTRITION. OUT SIDE PRESSURE .

PATHOPHYSIOLOGY :

PATHOPHYSIOLOGY HYPOTHERMIA ,INCREASED PHYSICAL ACTIVITY,DECREASED CARDIAC OUTPUT INCREASED METABOLIC DEMAND OF BODY BLOOD VESSELS FAILS TO DILATE . DECREASED BLOOD SUPPLY TO THE PART. DECREASED OXYGEN CONC. OF THE AREA . HYPOXIA

CLINICAL MANIFESTATION:

CLINICAL MANIFESTATION NEUROLOGIC EFFECTS : - RESTLESS - AGITATED - APPREHENSIVE - CHANGE IN LEVEL OF CONSCIOUSNESS - INCREASED LETHARGY - CHANGE IN MENTAL STATUS

CONTINUED …:

CONTINUED … RESPIRATORY EFFECTS : - RAPID & SHALLOW RESPIRATION - ABNORMAL LUNG SOUNDS - DECREASED ARTERIAL OXYGEN LEVEL. - PULMONARY VASOCONSTRICTION - ALVEOLAR COLLAPSE . - CRACLES

CONTINUED ..:

CONTINUED .. CARDIOVASCULAR EFFECTS : - RAPID HEART RATE {> 150 BPM} - CHEST PAIN - INCRESED CARDIAC ENZYME . - VENTRICULAR DILATION . - ABNORMAL HEART SOUNDS - S-T SEGMENT & T-WAVE CHANGES . - DYSRHYTHMIAS .

CONTD …:

CONTD … RENAL EFFECTS: INCREASED BUN INCREASED SERUM CREATININE LEVEL FLUID & ELECTROLYTE SHIFT ACID BASE IMBALANCE DECREASED URINARY OUTPUT - MAY LEAD TO ARF

CONTD …:

CONTD … G I EFFECTS : STRESS ULCERS G I BLEED DIARRHEA TRANSLOCATION OF BACTERIA IMPAIRED ABSORPTION OF NUTRIENTS ISCHEMIC GUT

CONTD.:

CONTD. HEPATIC EFFECTS : - DECREASED METABOLISM OF MEDICATION & METABOLIC WASTE PRODUCTS - INCREASED LIVER ENZYMES SKIN : - PALE , COOL & CLAMMY - CYANOTIC

CONTD …:

CONTD … HEMATOLOGIC EFFECTS : - BRUISES - PETECHIAE - INCREASED COAGULATION TIME

DIAGNOSTIC EVALUATION:

DIAGNOSTIC EVALUATION THOROUGH HISTORY PHYSICAL EXAMINATION NEUROLOGICAL ASSESSMENT 12 LEAD E C G X RAY HEMODYNAMIC MONITORING CONTINUOUS PULSE OXIMETRY

MEDICAL MANAGEMENT:

MEDICAL MANAGEMENT THROMBOLYTICS IN CASE OF EMBOLI NITROGLYCERINE ANTI PLATELETS & ANTICOAGULANTS ANTI BIOTICS

NURSING MANAGEMENT:

NURSING MANAGEMENT ASSESS FOR SIGNS & SYMPTOMS OF ISCHEMIA ASSESS FOR PAIN CHECK THE VITALS OF THE PATIENT MONITOR ABG ANALYSIS ADMINISTER MEDICATION AS PRESCRIBED BY THE PHYSICIAN ADMINISTER FLUID IF ISCHEMIA IS DUE TO HYPOVOLEMIA MAINTAIN INTAKE OUTPUT CHART SUPPLY REQUIRED AMOUNT OF OXYGEN

CONTD …:

CONTD … MONITOR FOR SIGNS OF COMPLICATION CONTROL ANY EXTERNAL BLEEDING PROVIDE BLANKET TO THE PATIENT IF FEELING COLD PREVENT FROM INJURY MONITOR THE SKIN COLOR ,TEMP ,PERIPHEL PULSE CAPILLARY REFILL TIME KEEP THE PATIENT WARM & DRY MAINTAIN THE PERSONAL HYGIENE OF PATIENT GIVE REASSURANCE TO THE FAMILY &PATIENT

SUMMARIZATION:

SUMMARIZATION INTRODUCTION OF HYPOXIA DEFINITION ETIOLOGICAL FACTORS TYPES CLINICAL MANIFESTATION OF HYPOXIA NURSING MANAGEMENT INTRODUCTION OF ISCHEMIA DEFINITION ETIOLOGICAL CAUSES PATHOPHYSIOLOGY EFFECTS ON VARIOUS BODY PARTS

CONTD ….:

CONTD …. DIAGNOSTIC EVALUATION MEDICAL MANAGEMENT NURSING MANAGE MENT

BIBLIOGRAPHY:

BIBLIOGRAPHY LEWIS et.al, 2003 , “MEDICAL SURGICAL NURSING” ,6 TH ED., MOSBY UNITED STATES SUDDARTH’S & BRUNNER ,2004 , “TEXT BOOK OF MEDICAL SURGICAL NURSING” ,10 TH ED. LIPPINCOT WIILLIAMS &WIILLKINS DRAZEN et. al, 2000 , “TEXT BOOK OF MEDICINE ” 21 ST ED.’VOL 1 ST, HARCOURT ASIA PVT. LTD. BARBARA et al , “FUNDAMENTALS OF NURSING” 7 TH ED., DORLING KINDSLEY PVT. LTD.

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THANKS

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