Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory Care Seminar > Ch.1 Oxygen and Medical Gas Therapy (Test 2) > Flashcards

Ch.1 Oxygen and Medical Gas Therapy (Test 2) Flashcards

1
Q

A pt is receiving O2 from an E cyclinder at 4 L/min through a nasal cannula. The cylinder pressure is 1900 psi . How long will cylinder run until it is empty?

A. 47 min
B. 1.7 h
C. 2.2 h
D. 3.6 h

A

2.2 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

After the RT sets up a nonrebreathing mask on a pt at a flow of 10 L/min, the reservoir bag collapses before the pt finishes inspiring. The RT should do which of the following?

A. Change to a simple O2 mask at a flow of 10 L/min
B. Remove the one-way valve from the exhalation port.
C. Place the pt on CPAP
D. Increase the flow to 15 L/min

A

Increase the flow to 15 L/min

The reservoir bag on a partial or nonrebreathing mask should remain one-third to one-half full at all times. If the bag contains less gas, then it is an indication of inadequate flow to the mask, and the flow from the flowmeter must be increased. Typically, flows of 10 to 15 L/min are necessary to maintain adequate flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A patient with carbon monoxide (CO) poisoning can best be treated with which of the following therapies?

A. Nasal cannula at 6 L/min
B. Simple O2 mask at 10 L/min
C. CPAP and 60% O2
D. Nonrebreathing mask

A

Nonrebreathing mask

Hemoglobin (Hb) has a greater affinity for carbon monoxide (CO) than it does for O2, but its affinity decreases as the O2 level in the blood increases. Therefore the higher the PaO2, the less affinity Hb has for CO, and O2 is then able to combine with Hb. A nonrebreathing mask provides the highest level of O2 of the four choices. It is important to provide the highest percentage of O2 available.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The following blood gas levels have been obtained from a patient using a 60% aerosol mask.

pH 7.47
PaCO2 31 mm Hg
PaO2 58 mm Hg

What should the respiratory therapist recommend at this time?

A. Place the patient on CPAP.
B. Increase the O2 to 70%.
C. Intubate and place the patient on mechanical ventilation.
D. Change to a nonrebreathing mask.

A

Place the patient on CPAP.

Hyperventilation with a PaO2 of only 58 mm Hg while receiving 60% O2 indicates intrapulmonary shunting with refractory hypoxemia. Intrapulmonary shunting is caused by atelectasis, pulmonary edema, or consolidated alveoli, none of which will improve by a simple increase in the O2 level. If the alveoli are collapsed or full of fluid or consolidated material, O2 will not be able to enter these alveoli and diffuse into the blood, and no matter how high the O2 level is increased, the PaO2 will not increase significantly. To deliver more O2 into the alveoli, apply pressure to increase the surface area for gas exchange to take place. This is accomplished with CPAP. In almost all cases on the exam, if the patient in the question is hyperventilating in response to hypoxemia with 60% O2 or higher, do not increase the FiO2. Apply CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The respiratory therapist receives an order to set up a moderate level of O2 on a patient who arrives in the ED breathing at a rate of 35 breaths/min. Which of the following O2 delivery devices is most appropriate to use in this situation?

A. Simple O2 mask at 10 L/min
B. Nasal cannula at 4 L/min
C. Nonrebreathing mask at 15 L/min
D. Air-entrainment mask at 40% O2

A

Air-entrainment mask at 40% O2

Choices A, B, and C are all considered low-flow O2 devices. If a patient has a respiratory rate of more than 25/min or an inconsistent VT, high-flow devices such as the air-entrainment mask are recommended. A moderate level of O2 is a range of 40% to 60%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A severe COPD patient arrives in the emergency department on a 2 L/min nasal cannula. Arterial blood gas results follow:

pH 7.32
PaCO2 67 mm Hg
PaO2 62 mm Hg
HCO3 38 mEq/L

Which of the following is the most appropriate recommendation?

A. Increase the liter flow to 4 L/min.
B. Maintain the current O2 level.
C. Institute noninvasive positive pressure ventilation (NPPV).
D. Place on a nonrebreathing mask at 12 L/min.

A

Maintain the current O2 level.

These ABG results represent normal values for a severe COPD patient. Although the PaCO2 level is increased, provided the pH is 7.30 or higher, the patient is ventilating adequately; therefore noninvasive ventilation is not indicated. Keeping the PaO2 in the 50 to 65 mm Hg range is acceptable for a patient with chronic hypoxemia. Increasing the O2 level and thereby increasing the PaO2 above 70 mm Hg increases the possibility of reducing the patient’s drive to breathe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The physician has ordered O2 to be set up on a patient who has a spontaneous tidal volume of 500 mL and an inspiratory time of 1 second. Which of the following O2 delivery devices will deliver a flow that meets or exceeds this patient’s inspiratory flow?

A. 35% air-entrainment mask at 6 L/min
B. 60% aerosol mask at 12 L/min
C. Nonrebreathing mask at 15 L/min
D. Simple O2 mask at 10 L/min

A

35% air-entrainment mask at 6 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A patient breathing 50% oxygen has a PaO2 of
248 torr. Which of the following should the respiratory therapist recommend?

A. Discontinue oxygen therapy.
B. Decrease the oxygen to 30%.
C. Titrate oxygen to maintain an SpO2 .93%.
D. Repeat the blood gases because the PaO2 is not
possible on this FiO2.

A

Titrate oxygen to maintain an SpO2 .93%

A PaO2 of approximately 250 torr is normal on 50% oxygen. Titrating the oxygen level is indicated. Remember, to determine the normal PaO2 on any given O2%, multiply the O2% by 5. This is an approximation. If titrate was not a choice, then discontinue oxygen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A patient is receiving 30% oxygen via an air- entrainment mask at a flow of 5 L/min. The total flow delivered by this device is which of the following?

A. 36 L/min
B. 45 L/min
C. 54 L/min
D. 60 L/min

A

45 L/min

To calculate the total flow delivered by a high-flow O2 delivery device, the sum of the air/O2 ratio parts for the O2 percentage of the device is multiplied by the flow from the flowmeter supplying the device. The air/ O2 ratio for 30% is 8:1. In other words, for every 1 L of O2 flow from the flowmeter, 8 L of air is being en- trained into the device. Add the ratio parts together, 8 +1= 9, and then multiply by the liter flow of 5 L/min: 9 x 5 = 45 L/min.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cylinders are constructed of chrome
molybdenum steel.

A

know

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Gas cylinders are stored at high pressures; a
full O2 cylinder contains _______ psig pressure.

A

2200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

O2 tank color

A

green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

helium

A

brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

carbon dioxide

A

gray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

nitous oxide

A

light blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

cyclopropane

A

orange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ethylene

A

red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

air

A

yellow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

co2/o2

A

gray and green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Heliox

A

Brown and green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indications for O2 Therapy (3)

A
  1. Hypoxemia
  2. Labored breathing or dyspnea
  3. Increased myocardial work
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs and Symptoms of Hypoxemia (7)

A
  1. Tachycardia
  2. Dyspnea
  3. Cyanosis (unless anemia is present)
  4. Impairment of special senses
  5. Headache
  6. Mental disturbance
  7. Slight hyperventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

To determine what a normal PaO2 is while any oxygen percentage is being breathed, multiply the percentage by 5. For example, a normal PaO2 for a patient breathing 40% oxygen would be approximately 200 torr
(40 x 5) This is an approximation but can be helpful on the exam. If a patient on 40% has a PaO2 of 300 torr, this represents a laboratory error because it’s not possible to have a PaO2 that high on 40%. If the PaO2 is approximately five times the O2% that the patient is breathing, titrate the oxygen level or discontinue the oxygen if titration is not a choice.

A

KNOW

24
Q

Complications of O2 Therapy (5)

A
  • Respiratory depression
  • Atelectasis
  • O2 toxicity
  • Reduced mucociliary activity
  • Retinopathy of prematurity (ROP)
25
Q

What are the 4 types of hypoxia?

A
  • Hypoxemic hypoxia
  • Anemic hypoxia
  • Stagnant (circulatory) hypoxia
  • Histotoxic hypoxia
26
Q

Hypoxemic hypoxia

A

Is caused by lack of O2 in the blood as a result of:
1. Inadequate O2 in the inspired air
2. Alveolar hypoventilation
3. V/q mismatch

27
Q

If the flowmeter is turned off completely but gas is still bubbling through the humidifier or is heard coming from the flowmeter, the valve seat is faulty and the flowmeter should be replaced **

A

Know

28
Q

The advantage of the Bourdon gauge is that, unlike Thorpe tube flowmeters, it is not position dependent. It reads just as accurately in a horizontal position as it
does in a vertical position. This makes it the flowmeter of choice when transporting a patient with an oxygen tank. **

A

Know

29
Q

Reduced mucociliary activity: Maintain FiO2

A

below 60%

30
Q

If a normal PaO2 level cannot be maintained with a 60% O2 mask, a large shunt is probable and should not be treated with higher O2 concentrations. What shoud be adminstristered?

A

CPAP

31
Q

Remember if a pt is breathing over 25 breaths per min do not use a low flow breathing o2 device. Instead use an

A

Air entrainment mask for high flow delivery

32
Q

A blender consists of pressure-regulating valves that regulate O2 and air inlet pressure, a mixture control (precision metering device), and an audible alarm system that sounds if there is a drop in inlet pressure.

A
33
Q

When using a blender/nebulizer to provide O2, make sure the nebulizer

A

set on 100%

34
Q

Alveolar Air equation

A

Pb-ph20 x FiO2 - PaCO2 x 1.25

35
Q

Heliox- Helium does not support life and therefore must be mixed with O2.

A

Know

36
Q

Two common mixtures are:

A

a. 80% helium and 20% O2
b. 70% helium and 30% O2

37
Q

Heliox mixtures are safe and may be of benefit in the treatment of:

A

a. Obstruction from secretions
b. Asthma (during episodes of bronchospasm)
c. Airway obstructions (tumors, foreign bodies, tracheomalacia)

38
Q

For an 80:20 mixture of helium and O2, multiply the flowmeter reading by 1.8 to determine the correct flow rate.

To deliver aspecific flow, divide the flow rate by 1.8.

A

Example:

An 80:20 heliox mixture is running through an O2 flowmeter at 10 L/min. What is the ACTUAL flow rate?

10 x 1.8 = 18L min

39
Q

EXAMPLE FOR HELIOX

A

You want to deliver 12 L/min of an 80:20 heliox mixture to the patient. What must you set the O2 flowmeter on to deliver this flow rate?
12/ 1.8 = 6.6 L min

40
Q

For a 70:30 mixture of heliox, multiply the flowmeter reading by 1.6.

Divide by 1.6 to obtain a specific flow rate.

A

KNOW

41
Q

Nitric Oxide

A

Inhaled nitric oxide (NO) is a selective pulmonary vasodilator that improves blood flow to ventilated alveoli, which results in decreased intrapulmonary shunting and improved arterial oxygenation.

42
Q

When is Nitric Oxide indictaed?

A

It is indicated in term or near-term neonates of more than 34 weeks’ gestation who have evidence of persistent pulmonary hypertension of the newborn (PPHN).

43
Q

Which electrode calculates pcO2

A

Severinghaus

44
Q

This is composed of a platinum cathode and silver anode, and measures PO2

A

Clark electrode

45
Q

In order to achieve accurate ptO2 the skin probe temperature must be __ which may lead to burning of the skin

A

44 c

46
Q

PtcO2 is reliable with skin temperature even as low as

A

37 c

47
Q

TC monitoring time

A

8-12 hours

48
Q

Changing sites as often as every 2 hours may be necessary in small premature neonatal to avoid thermal injury

A

KNOW

49
Q

Examples of O2 analyzers

A
  • Galvanic cell o2
  • Polarographic O2 analyzer
50
Q

How is the galvanic cell used?

A

Electrolyte gel is used to chemically reduce O2 to electron flow

51
Q

How is the polarographic O2 used?

A

A battery polarizes the electrodes to allow O2 reduction to occur, which gives off electron flow

52
Q

For both the galvanic and polarographic the Clark electrode is used to measure O2 concentration

A

KNOW

53
Q

Troubleshooting galvanic

A

Check gel

54
Q

Troubleshooting polarographic

A

Check battery

55
Q

Indications of hyperbaric o2 therapy (6)

A
  • CO poisoning
  • Cyanide poisoning
  • Decompressing sickness (“the bends”)
  • Gas gangrene
  • Gas embolism
  • Osteonecrosis
56
Q

Causes of inaccurate reading on pulse ox

A
  • low blood perfusion
  • co poisoning
  • severe asthma
  • hypotension
  • hypothermia
  • cardiac arrest
  • nail polish (especially blue, green, brown, and black)
  • ambient light sources
  • dark skin
57
Q

Hemoximetry

A

Respiratory Care Seminar (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions