Chap 10, 11, 12, 13, 14, 18, 20

Question 1

Signs of Hypoxia

Answer 1

Grunting, Retraction, Nasal Flaring, and Cyanosis

Question 2

Acceptable PaO2 in a neonate / SaO2

Answer 2

60mmHg (SaO2 90%)

Question 3

Acceptable PaO2 in Peds / SaO2

Answer 3

80-100mmHg (SaO2 95-99%)

Question 4

When Hypoxia present SpO2 and PaO2

Answer 4

SpO2 88-95%, PaO2 50-80mmHg are acceptable

Question 5

Hazards of O2 therapy (neonate)

Answer 5

Retinopathy of prematurity (ROP) from high PaO2
Atelectasis
Pulm Vasodilation
O2 toxicity (pulm fibrosis) from high FiO2

Question 6

Equipment from neonate

Answer 6

Cannula, HFNC, Air-Entrainment Neb, Hood, Isolette, Resuscitation bags

Question 7

Best choice for long term low flow O2 delivery

Answer 7

Cannula, usually tolerated well (tape to face, ears dont hold)

Question 8

Cannula flow

Answer 8

Low flow flowmeters (0.1-3lpm)- blenders to adjust to FiO2

Question 9

Disadvantages of NC

Answer 9

Inadvertent CPAP, Dries nasal mucosal, Inaccurate FiO2 varies with pts (Resp pattern, size, age), assess by pulse ox or ABG

Question 10

High Flow NC

Answer 10

Poorly tolerated by conscious infants/ children

for moderate FiO2s- more control of FiO2

Question 11

Varietes available of HFNC

Answer 11

Non-rebreathing, simple, venture(air-entrainment)

Question 12

Air Entrainment Neb

Answer 12

Need high moisture, need precise FiO2, Heat and humidity for application to artificial AR, Heat when applying to infants

Question 13

Air Entrainment neb devices

Answer 13

Aerosol mask, Trach collar, face tent, hood , Tpiece

Question 14

Best choice for FiO2 control

Answer 14

Hood

Question 15

Hood: must be heated and humidified bc

Answer 15

O2 must be heated and humidified:

Heated bc neos are susceptible to hypothermia, Humidified bc dry gas= mucosal damage

Question 16

Mixed gases may be supplied by a blender and either a heated humidifier or heated aerosol (hood)

Answer 16

Blender is quiet and accurate
Heated neb on 100% with blender to adjust FiO2, cuts down on noise
Heated humidifier most efficient
Must have enough flow to flush thro system

Question 17

Analyze O2 in hood

Answer 17

as near to pt mouth as possible, dont keep analyzer in all the time due to moisture

Question 18

Isolette

Answer 18

O2 must be warmed and humidified
O2 analyzer near pts head
FiO2 of 25-30% or less

Question 19

Resuscitation Bags

Answer 19

Self Inflating, use reservoir
Flow Inflating
Always have a manometer in line

Question 20

Things to consider with children and aerosols administration of meds

Answer 20

Large tongue in proportion to AW
Nose preathers
Narrow AW diameter
Rapid RR
Smaller Vt
Cant do breath hold
Increase insp. flow rates when in distress or crying

Question 21

Aerosolized drug therapy

Answer 21

SVN, MDI, DPI, Small particle aerosol generator (SPAG)