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Respiratory Skills > Chapter 42 Test > Flashcards

Chapter 42 Test Flashcards

1
Q

Overall goal of O2 therapy

A
  • maintain adequate tissue oxygenation
  • minimizing cardiopulmonary work
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2
Q

Clinical objectives for O2 therapy

A
  • correct documents or suspected acute hypoxemia
  • decrease symptoms of chronic hypoxemia
  • decrease workload of cardiopulmonary system
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3
Q

What is hypoxemia

A

low O2 levels in the blood

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4
Q

3 basic ways to know if patient needs O2 therapy

A
  • ABGs or other lab measures
  • patients specific clinical problem or condition such as exacerbation of asthma
  • perform patient assessment to identify need for O2
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5
Q

Common Hazards for O2 therapy

A
  1. Fire hazard
  2. O2 toxicity
  3. Depression of Ventilation
  4. Retinopathy of Prematurity (ROP)
  5. Absorption Atelectasis
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6
Q

Fire Hazard

A

O2 is nonflammable but gas supports combustion

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7
Q

O2 toxicity

A

High levels of O2 in the blood
two factors to determine:
- PaO2
- exposure time

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8
Q

O2 toxicity “circle”

A

O2 toxicity > Increased shunting > Low PaO2 > Increased FiO2

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9
Q

Type I alveolar cells

A

where gas exchange occurs

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10
Q

Type II alveolar cells (septal cells)

A

secrete alveolar fluid (surfactant)

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11
Q

Alveolar dust cells

A

wandering macrophages remove debris

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12
Q

Depression of Ventilation

A

When SOME COPD patients are placed on high levels of O2, it suppresses their chemoreceptors which depresses ventilatory drive

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13
Q

Retinopathy of Prematurity

A

abnormal eye condition in premature or low-weight babies who receive supplemental O2

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14
Q

Absorption Atelectasis

A

Breathing high levels O2 quickly depletes N2 levels. as N2 decreases, venous gases decrease

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15
Q

AARC develop guidelines for each procedure

A
  • indication
  • contraindication
  • precautions
  • possible complications
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16
Q

Low Flow Device

A

referred as a variable performance device, low flow cannot meet patients inspiratory flow demand (variable)

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17
Q

Nasal Cannula Flow Rate and FiO2

A

1 lpm = 0.24
2 lpm = 0.28
3 lpm = 0.32
4 lpm = 0.36
5 lpm = 0.40
6 lpm = 0.44

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18
Q

Advantages of Nasal Cannula

A
  • can be used on adults, children, and infants
  • easy to use
  • disposable
  • doesn’t cost very much
  • very well tolerated (eat, sleep)
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19
Q

Disadvantages of Nasal Cannula

A
  • unstable, easily dislodged
  • uncomfortable at high liter flow
  • can cause dryness, bleeding, polyps
  • mouth-breathing may reduce FiO2
20
Q

Simple Mask Flow Rate and FiO2

A

5 lpm = 0.35
6-7 lpm = 0.40
8-9 lpm = 0.45
10 lpm = 0.50

21
Q

Simple mask cannot go below ____ l/min or the patient may be at risk for CO2 retention

A

5 L/min

22
Q

Advantages of using a simple mask

A
  • can be used on adults, children, and infants
  • quick and easy to apply
  • disposable
  • inexpensive
23
Q

Disadvantages of using a simple mask

A
  • uncomfortable, claustrophobia
  • must be removed for eating
  • prevents radiant heat loss
  • risk of aspiration if patient vomits
  • masks cannot be humidified
24
Q

Partial Rebreather Mask Flow Rate and FiO2

A

10-11 lpm = 0.40-0.50
11-12 lpm = 0.50-0.60
12-13 lpm = 0.60-0.70
13-14 lpm = 0.70+
14-15 lpm = 0.70+

25
Q

Advantages of using PRB mask

A
  • can be used on adults, children, and infants
  • quick and easy to apply
  • disposable
  • inexpensive
  • can provide moderate to high FiO2
26
Q

Disadvantages of using a PRB mask

A
  • uncomfortable, claustrophobia
  • must be removed fro eating
  • prevents radiant heat loss
  • risk of aspiration if patient vomits
  • masks cannot be humidified
  • potential suffocation hazard
27
Q

Nonrebreather Mask Flow Rate and FiO2

A

10-11 lpm = 0.60
11-12 lpm = 0.60-0.70
12-13 lpm = 0.70- 0.80
13-14 lpm = 0.80+
14-15 lpm = 0.80+

28
Q

Advantages of using a NRB mask

A
  • can be used on adults, children, and infants
  • quick and easy to apply
  • disposable
  • inexpensive
  • can provide high FiO2
29
Q

Disadvantages of using a NRB mask

A
  • uncomfortable, claustrophobia
  • must be removed for eating
  • prevents radiant heat loss
  • risk of aspiration if patient vomits
  • mask cannot be humidified
  • potential suffocation hazard
30
Q

3 things used in the initial selection or change in O2 delivery

A

purpose, patient, and performance

31
Q

What is purpose of O2 therapy

A

to increase the patient’s FiO2 sufficiently to correct arterial hypoxemia and or minimizing cardiopulmonary work

32
Q

What things are you looking at on a patient for O2 therapy

A
  • severity and cause of hypoxemia
  • patient age group
  • degree of consciousness and alertness
  • presence or absence of tracheal airway
  • stability of minute ventilation
  • mouth breathing vs. nose breathing
33
Q

What is the performance for O2 therapy

A

O2 systems vary according to actual FiO2 delivered and stability of FiO2 under changing patient demands.

34
Q

according to AARC guidelines for O2 therapy for adults, how often should O2 delivery systems be checked?

A

Once a day

35
Q

High Flow Device

A

device that is able to meet or exceed the patient’s inspiratory flow demands so the patient does not have to entrain room air (fixed)

36
Q

High Flow Devices:

A
  • Air-entrainment mask (AEM)
  • Air-entrainment nebulizer (AEN) or Large Volume Nebulizer (LVN)
  • High flow nasal cannula
37
Q

The smaller the orifice, the greater the ____ of O2 and more ___ is entrained

A

velocity, air

38
Q

To increase total flow for a LVN you can:

A

-Connect 2 or more nebulizers together (double flow)
- set nebulizer to a low concentration and bleed-in O2
- add open reservoir to expiratory side of T-tube

39
Q

4 types of interface used with AEN/LVN

A
  1. aerosol mask
  2. face-tent
  3. tracheostomy collar
  4. t-tube or t-piece
40
Q

2 major problems with LVNs

A
  1. ensuring adequate flow at moderate to high FiO2s
  2. Downstream resistance affects the FiO2 device
41
Q

Why do we do a double flow system?

A

so air to O2 ratio meets the fiO2 requirements along with more liter flow

42
Q

Low Flow Devices

A
  • nasal cannula
  • simple mask
  • partial rebreather
  • non-rebreather
43
Q

What are you partially rebreathing with a PRB

A

Headspace gas and mostly O2

44
Q

Explain how a Venturi mask works

A

devices have a simple restricted orifice or jet through which O2 flows at high velocity. air is entrained by shear forces at the boundary of jet flow

45
Q

Venturi mask FiO2 range

A

0.24 - 0.55

46
Q

LVN FiO2 range

A

0.28 - 0.98-1.0

47
Q

Why do we test an O2 analyzer?

A

to make sure the analyzer can go all the way up to proper FiO2 delivering to patient

Respiratory Skills (3 decks)

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