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Basic Respiratory Therapy Procedures And Lab > BRTP04 Theory of Oxygen Administration > Flashcards

BRTP04 Theory of Oxygen Administration Flashcards

1
Q

PICO2

A

Partial pressure of inspired carbon dioxide

Normal value
0.23 mmHg

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2
Q

PIO2

A

Partial pressure of inspired oxygen

Normal value 159 mmHg

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3
Q

PAO2

A

Partial pressure of oxygen in the alveoli

99-100 mmHg

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4
Q

PaO2

A

Partial pressure if oxygen in arterial blood

80-100 mmHg

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5
Q

PvO2

A

Partial pressure of oxygen mixed in venous blood

40-45mmHg

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6
Q

SaO2

A

Oxygen saturation of Hemoglobin in arterial blood

95-97.5%

(Found when blood is drawn ABG)

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7
Q

SvO2

A

Oxygen saturation of hemoglobin in mixed venous blood

75%

(Found w pulse oximeter)

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8
Q

PvCO2

A

Partial pressure of carbon dioxide in mixed venous blood

45 mmHg

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9
Q

PACO2

A

Partial pressure of carbon dioxide in the Alveoli.

40 mmHg

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10
Q

PaCO2

A

Partial pressure of carbon dioxide in arterial blood

35-45 mmHg

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11
Q

CaO2

A

20.4%

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12
Q

Respiration has 3 basic processes

A
  1. Ventilation
  2. External respiration- happens at AC membrane
  3. Internal respiration- gas exchange at tissue
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13
Q

Aerobic metabolism

A

Sustains life, Metabolism that occurs IN THE PRESENCE OF OXYGEN

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14
Q

Anaerobic metabolism

A

Functions WITHOUT AIR OR OXYGEN

In the cytoplasm

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15
Q

Oxygen definitions

A

Colorless, tasteless, transparent gas

In atmosphere 21%
Density 1.429 g/L
Supports combustion

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16
Q

Hypoxia

A

Lack of oxygen at the tissue level; doesn’t meet cells metabolic needs

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17
Q

Hypoxemia

A

Lack of oxygen in the arterial blood (decreased PaO2)

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18
Q

Hyperoxia

A

Increased levels of oxygen to the tissues usually due to the use of supplemental O2.

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19
Q

Hypocapnea or hypocarbia

A

Decrease in CO2 in the blood

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20
Q

Hypercapnea or hypercarbia

A

Increase in CO2 in the blood

Remember this is associated with abnormal drowsiness

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21
Q

Secondary polycythemia

A

Increased production of red blood cells. A compensatory mechanism of the body to decreased levels of oxygen in the blood (PaO2). More RBCS available to carry oxygen to the tissues.

Remember it’s always a secondary issue, a separate issue has to exist for this one to begin.

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22
Q

Cyanosis

A

Cyanosis is visible bluish tinge if the skin and mucous membranes.

Visible when you have 5gm/100ml or 5gms% of blood of dissociated hemoglobin. (Most important part of this definition)

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23
Q

Time limits to diffusion

A

Pulmonary blood is normally exposed to alveolar gas for 0.75 seconds during exercise it may fall to 0.25 seconds.

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24
Q

Atmospheric pressure at sea level

A

14.7 psi

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25
Q

Dead space

A

Air present with no blood flow

26
Q

Shunt

A

Blood flow with no airflow

27
Q

4 types of tissue hypoxia

A
  1. Hypoxemia aka hypoxic hypoxia
  2. Anemic hypoxia
  3. Circulatory hypoxia
  4. Histotoxic hypoxia (dysoxia)
28
Q

Hypoxemia

A

Also known as hypoxic hypoxia

Inadequate delivery of oxygen to the lung or “from the lung to the blood”.

Responds well to oxygen therapy (except shunts)

29
Q

Causes of hypoxemia

A

Hypoventilation, high altitude, shunt (atelectasis), V/Q mismatch (under ventilated alveolar lung regions) diffusion

30
Q

Anemic hypoxia

A

A hemoglobin deficiency. Low amounts of hemoglobin (Hb) in the blood

Common in blood loss.

Responds well to oxygen therapy

31
Q

Causes of anemic hypoxia

A

Loss of Hb, decreased Hb production, abnormal Hb, or impaired chemical combinations of Hb with O2 (carbon monoxide poisoning)

32
Q

Circulatory hypoxia

A

Stagnant or hypoperfusion or LOW BLOOD FLOW.

Associated with ischemia (tissue death)

Oxygen therapy limited (other actions need to be to be taken for oxygen to effective)

33
Q

Causes of circulatory hypoxia

A

Sufficient blood flow is not reaching the tissue and therefore oxygen is not being delivered.

(Cardiac pump failure, CHF, shock)

34
Q

Histotoxic hypoxia (dysoxia)

A

Poisoning of the cellular oxygen utilization mechanism has occurred. The cell is not able to accept O2 from the blood.

Cyanide poisoning is the most common example

Does not respond to O2 therapy at all

Antidote is the only cure

35
Q

Acute vs chronic

A

Acute is effects felt currently, usually can be resolved quickly

Chronic is progressive, non curable and dealt with longer than 3 months

36
Q

Acute hypoxia signs and symptoms (try to know as many as you can)

A

Tachypnea, increase RR, increased depth of RR

tachycardia, hypertension, increased Cardiac output, arrhythmia

Confusion, lethargy, restlessness, loss of muscle coordination

Liver damage kidney damage

37
Q

Chronic hypoxia signs and symptoms

A 
Persistent mental and physical fatigue 
Decrease in physical activity 
Barrel chest (increase AP diameter)
Clubbing of fingernails
Secondary polycythemia 
Increase in size of heart (right sided heart failure) (for pulmonale) 
Jugular vein distention (JVD)
38
Q

What ranges indicate hypoxemia (need for oxygen use)

A

PaO2 less than 60 mmHg

SaO2 less than 90%

39
Q

When is Hypoxia suspected

A

Increase work of breathing
Increase work of heart
Severe trauma (traumatic brain injury)
Acute myocardial infarction (heart attack)
Short term therapy, post anesthesia recovery

40
Q

Oxygen toxicity

A

Can I occur as a result of an increased FiO2.

FiO2 greater than 50% for longer than 24-48 hours.

41
Q

Oxygen toxicity early phase

A 
Tachypnea 
Fatigue
Anxiety
Irritation of trachea 
Mild cough
Pain in inspiration
Decreased vital capacity

(Acute issues)

42
Q

Oxygen toxicity late phase

A 
Atelectasis
Consolidation 
Lung fibrous
Pulmonary congestion
Pulmonary edema
Inflammation
Fibrin formation

(Chronic issues)

43
Q

2 types of chemical receptors

A

Central: (found in brain) responds to HIGH CO2

Peripheral: mainly responds to HIGH PaO2 (PaO2 less than 60 mmHg)

44
Q

Hypoxic drive

A

Chronic CO2 retainers breathe due to a lack of oxygen in the blood

The body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate respiratory cycle.

45
Q

Knocking out hypoxic drive

A

Can occur as a result of an increased PaO2

46
Q

Hypoxic drive with COPD patients

A

COPD patients don’t always respond to CO2 levels and will only respond to low PaO2z

47
Q

Bronchopulmonary dysplasia (BPD)

A

Fibrotic tissue damage caused by the exposure of high levels of inhaled oxygen (FiO2) to immature lung tissue of a premature baby.

HIGH FiO2

48
Q

Retinopathy of prematurity (ROP)

A

ROP occurs as a result of increased PaO2 greater than 80 mmHg

Irreversible damage to the retina if an infant due to exposure to high levels in the arterial blood

HIGH PaO2

49
Q

O2 induced hypoventilation

50
Q

Absorption Atelectasis

A

Collapse if alveoli as the result of high levels of oxygen (increase FiO2) in the inhaled air causing elimination of nitrogen from lung

Increased FiO2 collapses alveoli. Lack of nitrogen met with increased O2 causes this.

51
Q

Normal oxygen content (CaO2)

A

Total content of arterial O2

CaO2= (Hb x 1.34x SaO2) + (PaO2 x .003)

52
Q

Alveolar air equation

A

PAO2=[(Pb-47) FiO2] - (PaCO2 x 1.25)

If FiO2 is 60% or more, then don’t include the factor of 1.25

Typical Pb will be 760

53
Q

P(A-a) gradient

A

P(A-a) gradient= PAO2-PaO2

Normal (A-a) gradient is 5-10 mmHg

No more than 65mmHg on 100% oxygen

54
Q

Diffusion

A

Done across the AC membrane

55
Q

Perfusion

A

Done across tissue

56
Q

O2 dissociation curve

Right shift

A

Shifts to the RIGHT decrease affinity (decreased attraction to O2)

Releases to tissue but won’t be picked up by lungs

57
Q

Causes of a right shift

A

Decrease in pH (increase in hydrogen ions)

Increase in temp
Increase 2,3 DPG
Increase in PaCO2

Increased PaCO2 causes acidosis

58
Q

O2 dissociation curve

Left shift

A

Shifts LEFT creates an INCREASED affinity

Oxygen transferred to the blood and Hb

59
Q

Left shift causes

A

Increase in pH (decrease in Hydrogen ions)

Decrease in temperature
Decrease 2,3 DPG
Decrease in PaCO2

Low PaCO2 is associated with alkalosis

60
Q

A/C membrane has 3 main barriers

A

Alveolar epithelium
Interstitial Space and it’s structures
Capillary endothelium

Basic Respiratory Therapy Procedures And Lab (11 decks)

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