Chapter 38 -oxygen Therapy

Question 1

What are the five patient rights of drug administration?

Answer 1

• right drug
• right dosage
• right patient
• right route of administration
• right time

Question 2

What is PaO2?

Answer 2

Partial pressure of oxygen in Arterial blood

Question 3

What is Sa02?

Answer 3

Saturated percent oxygen in arterial blood

Question 4

What is SPO2?

Answer 4

Saturated percent oxygen in peripheral blood

Question 5

What are AARC guidelines for indication of oxygen therapy?

4 things

Answer 5

• PAO2 less than 60 mm Hg or SPO2 less than 90%
• severe trauma
• hypoxemia suspected
• acute MI

Question 6

What’s a good rule of thumb when choosing FiO2 for oxygen therapy?

Answer 6

Choose the lowest possible FiO2 that can adequately oxygenate the patient

Question 7

Describe the oxygen toxicity cycle

Answer 7

O2 toxicity
      To
Increased shunting
      To
Low Pa02
      To
Increased FiO2
      To
O2 toxicity

Question 8

What is depression of ventilation?

Answer 8

• Occurs in COPD patients with hypercapnia

- ventilation goes down as oxygen levels go up

Question 9

What are the general goals oxygen therapy?

Answer 9

• to fix hypoxemia
• To decrease work of breathing
• lessen the work on the heart that hypoxemia creates

Question 10

What is a low flow oxygen delivery system?

Answer 10

• only a small portion of inspiratory vol comes from device

- variable FiO2 due to inconsistent breathing of patient

Question 11

What position should the prongs of a nasal cannula be facing?

Answer 11

Down

Question 12

What are some bad things to monitor with nasal cannula?

Answer 12

• Skin irritation due to long use

- May need to use humidifier if nasal area seems dry

Question 13

What’s the FI O2 range for a nasal cannula?

At what Lpm

Answer 13

22% at 1L

44% at 6L

Question 14

What is a transtracheal catheter?

Answer 14

A catheter used to administer oxygen through a small surgical incision in the trachea

Question 15

What is 2 benefits of using a transtracheal Catheter?

Answer 15

• reduced oxygen flow need due to direct insertion into trachea
• it can be hidden under the patient shirt due to area of incision

Question 16

What is a drawback of using a transtracheal catheter or a nasal catheter?

Answer 16

Mucus can plug the hole that leads into the airway blocking oxygen administration

Question 17

When would you use a simple mask?

Answer 17

When there was no nasal cannula available in emergency situations or if nasal cannula is contraindicated due to skin breakdown and such

Question 18

What’s the FI O2 range for simple mask?

Answer 18

.35 to .50

Question 19

What is a partial rebreathing mask?

Answer 19

A simple mask with the reservoir bag attached to it.

- oxygen is partially filled in the bag and patient Partially exhales into the bag as well

Question 20

What is a general rule for partial rebreather and nonrebreather masks?

Answer 20

There should be enough flow to adequately refill the reservoir bag with oxygen

Question 21

Describe a non-rebreather mask

Answer 21

• same as a partial rebreather except for

- three one-way valves, two valves covering the portholes on the mask and one valve covering the bag

Question 22

When would you use a non-rebreathing mask?

Answer 22

Patients requiring high amounts of oxygen for a short period of time.
Like:
-acute heart failure
-trauma
-CO poisoning

Question 23

What’s the general flow range for nonrebreather?

Answer 23

10 to 15 L per minute

Question 24

What’s the FI O2 arrange for a non-rebreather?

Answer 24

.60 - .80

Question 25

What is an air entrainment mask?

Answer 25

It’s a high flow delivery device that can provide precise FiO2s

Question 26

What determines the highest or the lowest

FI O2’s for high flow systems?

Answer 26

The smaller the diameter of the jet releasing oxygen will give decreased F I O2
But the smaller the entrainment port that feeds air into the system will give higher FI O2

Question 27

When would you use an air entrainment mask?

Answer 27

Patients who need precise concentration of oxygen like COPD patients who routine retain CO2 or patients that have highly variable respiratory patterns

Question 28

What’s one example of a patient who needs continuous oxygen therapy?

Answer 28

Patient who has recurrent heart attacks