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saecc > exam 1 - resp support > Flashcards

exam 1 - resp support Flashcards

1
Q

what is the primary indication for oxygen therapy

A

hypoxia

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2
Q

what is hypoxia

A

inadequate inspired oxygen
impaired pulmonary function
ineffective oxygen transport
increased oxygen demand not met by delivery

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3
Q

what values determine need for oxygen therapy

A

PaO2 < 60 mmHg
SpO2 < 90%

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4
Q

clinical signs for needs for oxygen therapy

A

cyanosis, dyspnea, tachypnea, tachycardia, anxiety

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5
Q

when to use flow-by oxygen

A

until another method can be employed
shock

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6
Q

which is better - baggie or face masks

A

baggie - better tolerated

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7
Q

what can an oxygen hood be made from

A

from an E-collar, or can be bought

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8
Q

what form of oxygen therapy uses alot of oxygen and can lose it very quickly

A

oxygen cage

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9
Q

when to use oxygen tent

A

sedated or depressed patient
short term immediate post op

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10
Q

when to use intranasal oxygen

A

prolonged management

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11
Q

when to use intratracheal oxygen

A

not common but used if contraindications are found for nasal

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12
Q

should you use intratracheal oxygen with a tracheal obstruction

A

no

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13
Q

does nasal or tracheal get more bang for buck

A

tracheal

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14
Q

what are guidelines only for O2 administration

A

FIO2 and PaO2

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15
Q

what flow rate do you start at

A

50-100 ml/kg/min

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16
Q

oxygen flow rates should be adjusted based on

A

SpO2 and PaO2
PaO2 above 100 mmHg

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17
Q

which oxygen administrations can reach FIO2 greater than 50-60%

A

bilateral intranasal and intratrachea via tracheostomy

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18
Q

what new oxygen administration can prevent ventilation and control FIO2

A

high flow oxygen

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19
Q

how to monitor oxygen therapy

A

CS - respiratory rate/character, MM color
pulse ox
arterial blood gas

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20
Q

where to put pulse ox on normal vs critical patients

A

tongue for normal
buccal mucosa for critical

21
Q

how does pulse ox work

A

red light absorbed by unsaturated Hg
infrared absorbed by oxyhemoglobin

22
Q

how to wean from oxygen therapy

A

monitor CS, SpO2, serial arterial blood gas, trials off oxygen

23
Q

when to continue oxygen

A

CS of hypoxia, SpO2 < 96%, PaO2 < 80 mmHg

24
Q

oxygen therapy complications

A

apnea in patients with severe respiratory disease, intrapulmonary shunting, oxygen toxicity

25
Q

what does oxygen toxicity look like

A

reasons to put on oxygen
edema, atelectasis, consolidation, congestion, hemorrhage, fibrosis, functional impairment

26
Q

pathogenesis of oxygen toxicity

A

cytotoxic peroxides and free radicals
starts after 24 hrs of 100% FIO2
death after 2-3 days 100% FIO2

27
Q

indications for positive pressure ventilation

A

PaCO2>55 mmHg
failure of oxygen therapy to reverse hypoxia
adjunctive treatment for intracranial hypertension

28
Q

2 overall techniques of positive pressure ventilation

A

manual - anesthesia bag, ambu bag
mechanical - controlled vs assisted, pressure vs volume related

29
Q

difference between controlled and assisted mechanical ventilation

A

controlled - machine initiates breath
assisted - animal initiates breath

30
Q

what is PEEP

A

positive end expiratory pressure

31
Q

what is CPAP

A

continuous positive airway pressure

32
Q

what do you use to treat alveolar collapse

A

PEEP or CPAP
decreases work of breathing

33
Q

usual settings for PEEP or CPAP

A

5-10 cm H2O

34
Q

specific instances where PEEP or CPAP indicated

A

100% oxygen doesnt achieve normoxia
greater than 50% inspired oxygen is required to maintain normoxia - puts at risk for oxygen toxicity

35
Q

when would you use high frequency ventilation

A

ventilaiton in presence of tracheal disruption

36
Q

is high frequency ventilatin used often in vet med

A

no - not available

37
Q

how to wean from ventilation

A

once stable, gradual reduction in minute ventilation so that spontaneous ventilation can start

38
Q

what to monitor when weaning from ventilation

A

blood gas, SpO2, ETCO2, respiratory pattern

39
Q

where does air get humidified in the body

A

nasopharynx and tracheobronchial tree

40
Q

effects of dry medical gases

A

increased humidification requirement
increased vaporization - cooling of liquid surfaces and patient heat loss
mucosal drying

41
Q

4 types of humidifiers

A

bubble
heated bubble
humidity exchange filters
nebulizers

42
Q

aerosol

A

fine suspension of liquid droplets in carrier gas

43
Q

what is the purpose of aerosol therapy

A

prevent dessication - water
loosen secretions and stimulate coughin - saline
treat resp disease - drugs

44
Q

how does size of particles in aerosols affect deposition

A

smaller particles deposit deeper in the airway

45
Q

how does rate and depth of breathing affect aerosol deposition

A

slow, deep breath = deep airway
rapid, shallow = upper

46
Q

3 types of nebulizers

A

jet, babbington, ultrasonic

47
Q

how to administer aerosol therapy

A

mask, enclosure, breathing circuit
for 15-20 min q 4-8 hrs
can also couple with coupage, bronchodilators

48
Q

what is a convenient way to deliver aerosols to lower airways in hospital setting

A

thru tracheostomy

49
Q

drugs delivered via nebulization

A

Abx - aminoglycosides
bronchodilators - aminophylline, beta 2 agonists

saecc (5 decks)

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