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Med-Gas > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What are hazards of O2 therapy?

A
  • Oxygen toxicity
  • Depression of ventilation
  • Retinopathy of prematurity
  • Absorption atelectasis
  • Fire hazards
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2
Q

What are the symptoms of oxygen toxicity?
- Maintain FiO2 below 50-60% if possible

A
  • substernal chest pain, coughing, restlessness
  • decreased diffusion
  • decreased lung surfactant / consolidation
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3
Q

What are the symptoms of depression of ventilation?

A

  • confused, lethargic, decreased respiratory rate, decreased chest expansion
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4
Q

what are the symptoms of Retinopathy of prematurity?

A

PaO2 is the issue!
- PaO2 = 40-60%

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5
Q

what is Absorption atelectasis?

A

Greater risk with FiO2> 50%,
- High O2 depletes Nitrogen from the lungs and reduces the production of surfactant this then causes atelectasis
- Post-op pts.
- Central nervous system dysfunction pts.
- Retained secretion pts.

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6
Q

KNOW THE MATH

A
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7
Q

KNOW THE TABLE FOR PAO2 AND FiO2

A
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8
Q

what is co-oximetry?

A

Arterial blood gases
- Measures the O2 carrying state in the blood (SaO2)
- uses wave lengths or light to measure

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9
Q

What is the troubleshooting with pulse oximetry?

A
  • Motion
  • Low perfusion
  • Ambient light
  • Electromagnetic Interference (MRI)
  • Nail polish
  • Dark skin pigmentation
  • edema
  • Anemia
  • CO2 poisoning
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10
Q

What are oxygen analyzers?

A
  • measure inspired O2 concentrations
  • most exam answers are calibration
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11
Q

what is the difference between fuel cell and clark analyzers?

A

Fuel cell
- battery powered
requires exposure to 100% air
Clark
- powered by fuel cells
- If unable to calibrate, change the fuel cell.

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12
Q

what are the home delivery systems and their indications?

A
  • Cylinders - for patients who use small volumes of gas
  • Liquid - patients who require high flow rates of oxygen
  • Concentrators - oxygen use
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13
Q

what is a transtracheal catheter?

A
  • long term use
  • Delivers and FiO2 of 22 -35%
  • surgically placed in trach
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14
Q

what is the resevoir cannula?

A

It requires less O2 to achieve the same effect

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15
Q

what are the classifications for hypoxemia on room air (21%)?

A
  • Normal – 80 to 100
  • Mild – 60 to 79
  • Moderate – 40 to 59
  • Severe - <40
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16
Q

what are the classifications for supplemental O2?

A
  • Corrected – 80 to 100
  • Under corrected - <80
  • Overcorrected - >100
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17
Q

what is carboxyhemoglobin?

A
  • The binding of CO prevents O2 from binding to hemoglobin.
  • it’s reversible
  • Pulse oximetry assumes that the patient has normal hemoglobin, PaO2, and SpO2 relationship (should be subtracted from SPO2)
18
Q

where are the sensor cites for pulse oximetry?

A

Finger, forehead (temporal), toe, foot (pedal), nose, wrist, hand

19
Q

what should we chart during pulse oximetry?

A
  • Date, time, actual reading
  • Patient’s position, activity level, location of monitoring
  • FiO2, delivery device
  • Probe type and placement
  • Patient’s clinical appearance
20
Q

what do you do when you get an incorrect reading on an oxygen analyzer?

A

Always recalibrate first before taking a second reading

21
Q

how do you get accurate results during oxygen analyzation?

A
  • Expose sensor to two gases - 100% and 21%
  • Expose to 100% and adjust to that reading (per Egans)
  • Expose to room air
  • Use only if calibrated
22
Q

What are oxygen analyzing results effected by?

A
  • Water
  • Positive pressure
  • High altitude – Most effected by altitude changes
  • Torn membrane
  • Lack of electrolyte gel
23
Q

what is the troubleshooting with oxygen analyzers?

A

Clark - change batteries
Galvanic fuel cell - replace fuel cell

24
Q

what should a prescription for home oxygen include?

A
  • Flowrate in L/min, concentration of device or both
  • Frequency of use in hours/day
  • Mode of delivery
  • Duration of need (up 12 months)- revaluated after 12 months
25
Q

what are the advantages and disadvantages of cylinder delivery devices?

A

advantage - prevents waste and can be stored easily
disadvantage - more costly, big and bulky

26
Q

what are the advantages and disadvantages of liquid oxygen delivery devices?

A

advantage - high flow system, has portable units,
disadvantage - professional refills, not good to store (evaporates), potential spills, frostbite and evacuation for 20 mins.

27
Q

what are the advantages and disadvantages of cencentrators?

A

Advantage - cheaper, uses room air, Generally go up to 5L but some have capability of 10L
Disadvantage - Runs on electricity, has limited portability, On higher flows O2 concentrations can fall to 85-93%, Less pure than tanks

28
Q

how do you calculate the duration of the liquid O2 system?

A

liquid weight X 860/flow

29
Q

what is the maintenance for a concentrator/

A
  • if molecular sieves aren’t working: analyze FiO2, check circuit breaker/fuse
  • Patients must check and change filters weekly
  • Outlet needs to be grounded
  • Backup system (tank or liquid) must be available in case of power failure – notify electric company
30
Q

what does an O2 conserving device do?

A

– uses flow sensor and valve to synchronize gas delivery with beginning of inspiration

31
Q

what are the advantages and disadvantages of Transtracheal catheter?

A

Advantages
- Upper airway acts as reservoir
- Portable O2 use / time extended
- Increased mobility
- Increased comfort and self image
Disadvantages
- High cost
- Mucus plugging
- Lost tract
- Patient selection, education, follow up
- Infection
- Bleeding

32
Q

what are the advantages and disadvantages of Reservoir cannula?

A

Advantages:
- Low O2 use
- Less discomfort due to decreased flow
- Increased mobility

Disadvantages:
- Replace every 3 wks due to membrane wear
- No humidification
- Unattractive and cumbersome
- Must exhale thru nose to reset membrane
- Pendant is heavy and can irritate ears/face

33
Q

what are the indications for pulse oximetry?

A
  • surgery
  • Lung disease
  • Heart disease
  • Sleep apnea
  • Oxygen therapy
  • SOB
34
Q

what happens to the SpO2 when smoke is inhaled?

A

the SpO2 level (oxygen saturation in the blood) decreases

35
Q

what are some oxygen in home safety rules?

A
  • store away from heat source
  • always position upright
  • have backup device
  • do not wear wool
  • do not use oil based products
  • do not use flammable products near oxygen
36
Q

how do we avoid complications of O2 therapy?

A

Monitor SpO2/ABG

37
Q

what are the normal values of O2?

A
  • PaO2 80-100mmHg (COPD 50-65mmHg)
  • PaCO2 35-45 mmHg
  • SaO2 95-100%
  • SpO2 94-100%
  • Clinically keep SpO2 > 92%
38
Q

What is the estimation for saturation?

A

PaO2 is 30 less than SaO2
- ex. PaO2 = 40mmHg then SaO2 = 70%

39
Q

ALWAYS TREAT PATIENTS, NOT MEASUREMENTS

A
  • always collect ABGs
  • do NOT use to measure hyperoxia
  • +/- for final readings
40
Q

what is the response time?

A
  • varies by manufacturer
  • vary from 10-60 seconds
41
Q

How do we assure an accurate reading on pulse oximetry?

A
  • ALWAYS compare HR on oximeter to patient’s actual HR
  • Most accurate: Compare SpO2 and PaO2
42
Q

what are the different types of oximetry?

A
  • Hemoximetry (Co-oximetry)
  • Pulse Oximetry
  • Venous Oximetry
  • Tissue Oximetry

Med-Gas (4 decks)

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