Impaired gas exchange results from direct pulmonary inefficiencies or be- cause of decreased cardiac output to the lungs.
When breathing is impaired, your lungs can’t easily move oxygen into your blood and remove carbon dioxide from your blood (gas exchange). This can cause a low oxygen level or high carbon dioxide level, or both, in your blood.
Signs and Symptoms
Premature infants are at risk for altered gas exchange due to immaturity of the lungs. Young children are at risk due to decreased alveolar surface and an increased exposure to respiratory pathogens. Older adults are at risk because of the structural and physiologic changes that occur with aging.
There are several body changes that happen as you get older that may cause a decline in lung capacity: Alveoli can lose their shape and become baggy. The diaphragm can, over time, become weaker, decreasing the ability to inhale and exhale. This change will only be significant when exercising.
Nursing Interventions for Impaired Gas Exchange. Administer oxygen as ordered to maintain oxygen saturation above 90%. Supplemental oxygen improves gas exchange and oxygen saturation. The patient may need a nasal cannula or other devices such as a venturi mask or opti-flow to maintain an oxygen saturation above 90%.
ineffective Breathing Pattern/risk for impaired Gas Exchange is possibly evidenced by risk factors of muscular impairment— wasting of respiratory musculature, decreased energy, fatigue, respiratory muscle fatigue; retained secretions—tracheobronchial obstruction; pain.
Commonly used NANDA-I nursing diagnoses for patients experiencing decreased oxygenation and dyspnea include Impaired Gas Exchange, Ineffective Breathing Pattern, Ineffective Airway Clearance, Decreased Cardiac Output, and Activity Intolerance.
In summary, available data suggest that chronic CHF induces structural changes as well as interstitial pulmonary edema in the lungs, which impair the efficiency of gas exchange; the extent of these changes reflects the severity of the CHF and probably its duration.
Improvements in gas exchange occur via several mechanisms: alterations in the distribution of alveolar ventilation, redistribution of blood flow, improved matching of local ventilation and perfusion, and reduction in regions of low ventilation/perfusion ratios.
In people older than 75, congestive heart failure occurs 10 times more often than in younger adults. Coronary artery disease is fairly common. It is often a result of atherosclerosis. High blood pressure and orthostatic hypotension are more common with older age.
6 Breathing Exercises for Older Adults
In general, compliance increases with aging . Compliance is an extrinsic parameter, which increases if alveolar sacs increase in size. Lungs with low compliance are stiff lungs and will require much greater pressure to reach a given volume.
As you age, it’s normal to notice a gradual decline in lung function, such as a decrease in the maximum amount of air that you can breathe out after you inhale as much air as you can.
Symptoms and Causes Heart conditions, including heart defects. Lung conditions such as asthma, emphysema, and bronchitis. Locations of high altitudes, where oxygen in the air is lower. Strong pain medications or other problems that slow breathing.
Inside the alveoli, oxygen enters your bloodstream, and carbon dioxide enters the airway to be exhaled. With age, these little air sacs can lose their shape and elasticity. They become flatter, so there is less area inside them. They also become less agile, as your alveolar wall thickens.