Chapter 30: Care of Patients Requiring Oxygen Therapy or Tracheostomy

Question 1

what three systems are essential for oxygen perfusion?

Answer 1

the respiratory system, cardiovascular, and hematologic systems (when one fails the other two compensate)

Question 2

hypoxemia vs hypoxia

Answer 2

hypoxemia: low O2 levels in the blood
hypoxia: low 02 levels in the tissues

Question 3

O2 content of atmospheric air

Answer 3

21%

Question 4

what is the Fio2?

Answer 4

the fraction of inspired oxygen, the purpose of oxygen therapy is to use the lowest Fio2 to achieve the desired results; remember just because we raise the Pao2 level, doesn’t mean we cure the underlying disease

Question 5

what is hypercarbia? what is important to know concerning oxygen therapy?

Answer 5

hypercarbia: when patient has increased levels of partial pressure of arterial carbon dioxide (PaCO2)
- problem is that low PaO2 levels are the patient’s primary driving force for breathing, so only 1-2 L/min should be administered via NC…why? to prevent decreased respiratory effort

Question 6

what is the best assessment to use for determining oxygen levels and need for oxygen therapy?

Answer 6

arterial blood gas (ABG) analysis

Question 7

What are the complications with oxygen therapy?

Answer 7

1. Combustion: while oxygen itself does not burn, it enhances flames and combustions; inform patient not to use candles in the house or take into the kitchen b/c of stove, smoking is not allowed around oxygen therapy in room or at home; post sign on the door informing visitors of this information
   - > all electrical equipment should be grounded (plugs, adapters) and all wires taped to floor and secured; frayed wires repair immediately
   - > no flammable solutions: high concentrations of alcohol or oil
2. oxygen-induced hypoventilation
   - for patients with hypoxic drive, eg the patient with lung disease and increased carbon dioxide retention/levels (high PaCO2, called hypercarbia), the chemoreceptors are no longer sensitive to carbon dioxide levels (happens when above 60 mm Hg) and thus oxygen levels are the driving force for respiration