Exam 6 - Oxygen Flashcards
0
Q
Oxygen Therapy
A
A. The administration of oxygen at a concentration greater than that found in the environmental atmosphere.
B. 21% concentration at sea level
C. The goal of oxygen therapy is to provide adequate transport of oxygen in the blood while decreasing the work of breathing and reducing stress on the myocardium.
1
Q
Alveoli
A
The site of gas exchange
2
Q
unlicensed personal
A
can not initiate oxygen therapy
3
Q
Hypoxemia
A
A decrease in the arterial oxygen in the blood.
4
Q
Hypoxia
A
A decrease in oxygen to the tissue
``````
shock
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turniquet
`````pulse increases
5
Q
Oxygen transport to the tissue is dependent on ……
A
- ——Cardiac output
- ——Arterial oxygen content
- ——Concentration of hemoglobin
6
Q
Indications for oxygen therapy
A
- –Respiratory problems caused by a decrease in partial pressure of arterial oxygen (PaO2) or Arterial oxygen saturation (SaO2)
- –Respiratory problems caused by conditions that increase O2 demands
7
Q
Oxygen Toxicity
A
50% O2 for 48 hours or longer can get toxic
8
Q
Absorption Atelectasis
A
- —-Collapsed lung
- —-Look for retained secretions—Look for Pain
- —-Turn, cough and deep breath
9
Q
Suppression of ventilation
A
- ——CO2 Narcosis - nonCOPD patient - build up of carbon dioxide
- ——Personality changes
- ——Confusion
- ——Coma
10
Q
Conbustible
A
- —O2
- —Vaseline
- —Shock
11
Q
Oxygen
A
Is the green port
12
Q
Medical Air
A
is the yellow port
13
Q
Nasal Cannula Flow Rate
A
1 L/min = 24%
6 L/min = 44%
Regular atmosphere is 21%
14
Q
Nasal Cannula
A
- –low flow device
- –most commonly used
- –nasal prongs inserted in each nare
- –can be used with humidity to alleviate discomfort
- –easily dislodged
15
Q
oxygen toxicity
A
- –high concentrations of oxygen given longer then 48 hours
- –causes decreased surfactant in lungs (surfactant keeps alveoli open)
- –end up with respiratory distress syndrome
- –client may have non cardiac pulmonary edema
- –c/o chest pain, tingling in extremities, SOB, restless, fatigued.
16
Q
Prevention of Oxygen Toxicity
A
- –Administer only the prescribed amount of oxygen
- –Monitor PaO2 levels
- –Report if well over 90 % at all times
- –Monitor ABG’s
- –Monitor for s/s of O2 toxicity
- –Decrease amounts of O2 as soon as client is able to tolerate and is prescribed by Dr.
17
Q
Absorption Atelectasis
A
- –Nitrogen in the air keep Alveoli open
- –When high levels of O2 is given (nitrogen is diluted and Alveoli collapse causing Atelectasis
- –Monitor for crackles and decreased breath sounds every 2 hours when O2 is started and often as needed there after.
18
Q
Prevention of Absorption Atelectasis
A
As soon as client is able to be weened off O2 — that is the key to prevention of Absorption Atelectasis
19
Q
CO2 Narcrosis (Supression of Ventilation) - in normal healthy person
A
- –Build up of carbon dioxide
- –personality changes
- –confusion - - coma
- –you breath normal when neuro receptors in the brain detect high levels of CO2
- –When CO2 levels build up the neuro receptors tell us to take a breath.
20
Q
CO2 Narcrosis (Supression of Ventilation ) in COPD patient
A
- –Chronic lung disease or COPD
- –the stimulus to breath is NOT the CO2 levels
- –COPD the person traps CO2, they do not expel it like they are suppose to
- –They have high levels of CO2 as a normal to them ( normal CO2 levels are 35-45)
- –Over time COPD clients may have high CO2 levels all the time (may even be 60 all the time)
- –The body can not depend on the CO2 levels to make it breath - - it is not a good neuro signal anymore
- –so it reverses and starts using the oxygen levels to determine if the person needs to take a breath
- –when their O2 levels start going low it causes them to take a breath
- –Have to be very careful when you administer O2 to these people, they may run a SaO2 level of 88 or even lower and if you raise that telling the body they have a high O2 and body says hey I don’t need to breath anymore
- –Observe for decreased respirations and drowsiness
- –O2 rate will usually be 1-2L/min
- –If the patient comes in highly compromised you may administer more than that but you will monitor this patient that their SaO2 levels are at a range you want it to be at without risking CO2 Narcrosis
21
Q
Conbustible
A
- –Oxygen–vaseline—shock
- –Oxygen does not burn but fire burns more readily in the presence of oxygen
- –ex: blowing on campfire when trying to get it started
- –no smoking- no open flames–no petroleum – no oil
- –croup tent - be careful with type of toy in croup tent that toy dont cause a spark
- –Delivery devices in the home should be 10 feet away from any open flame - and 5 feet away from electrical equipment
- –In hospital make sure you hook up flow meter to the green port for oxygen
- –have fire extinguisher close by
22
Q
Infections
A
- –Change tubing as recommended
- –NC tubing change every 7 days and prn if crusting on tubing or if tubing looks dirty
- –Wash out mask every day
- –tubing with condensation be sure when you empty water out you empty it in the sink or garbage and not back in the sterile water container.
23
Q
Methods of Oxygen Administration
A
- –Nasal Cannula
- –Simple Face Mask
- –Partial rebreather mask
- –non rebreather mask
- –Venturi Mask
24
Flow meter
Regulates the flow of Oxygen
25
Nasal Cannula
- -- 2 prong device that fits in the nares and around the ears
- --used for low to medium levels of O2 where precise levels are not essential
- --The amount of oxygen a person gets with a nasal cannula is determined by the depth and rate of respirations so its not a accurate method of O2 delivery
- --When Nasal Cannula flow rate is set from 1-6L/min you can get a range of 24-44% O2
- --Flow rates >6L is not recommended because they cause air swallowing and dry mucous membranes
- --Nasal Cannula is the best tolerated O2 delivery device
26
Safety for Oxygen delivery
- --Assess for skin breakdown
- --Assess behind ears for skin breakdown
- --Skin care is essential
- --Assess for Oxygen toxicity
- --No open flames
- --No petroleum
27
Simple Face Mask
- --Used for low to moderate O2 levels @ 6 - 8L/min it will deliver 40-60% O2
- --Amount of O2 delivered is determined by the rate and depth of respirations
- --May NOT deliver accurate levels
28
Partial Rebreather Mask
- --Used for moderate to high O2 administration
- --Has a bag that must be 2/3 inflated ---if not inflated it is NOT working
- --Adjust flow rate so bag does not deflate
- --Flow @ 8-11L/min will deliver 50-75 % Oxygen
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Non Rebreather Mask
- --12 L/min will deliver 80-100% Oxygen
| - --Will deliver up to 100% Oxygen
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Venturi Mask
- --Mask must be fit snug
- --4-10 L/min 24-50% oxygen
- --Will deliver regardless of respiratory rate or depth
- --It will deliver precise amounts
- --Color coded connectors
- --Attach connector and turn it to the flow you desire
31
Nasal Cannula
- --1-6L/min---------24-44%
- --Post Op
- --Recovery
- --Patients with a decrease in oxygen levels
- --Long term treatment at home
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Simple Face Mask
---6-8L/min----------40-60 %
- --Asthma
- --Pneumonia
- --Sepsis
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Partial Rebreather
---8-11L/min-----------50 - 75 %
- --Asthma
- --Pneumonia
- --Sepsis
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Venturi Mask
- --Most accurate and most reliable
- --4-10L/min--------24-50%
- --when controlled O2 is needed
- -- Book says best for chronic lung disease COPD
- --Very precise amount needed
35
Non Rebreather
- --12 L/min-------------80-100%
- --can get up to 100 %
- --very sick
- --about to go on a ventilator
36
Humidification
- --Needed for anyone receiving oxygen at a flow rate of >4L/min and are going to stay on O2 for a while.
- --When you bubble O2 through water it humidifies the O2
- --Humidification keeps airway moist and it helps loosen and move secretions
- --Sterile water is used and it is usually a disposable bottle that is connected to the flow meter.
- --If condensation occurs empty tubing in the sink or garbage NOT back in the sterile water container--prevent infection
- --With trach patients or babies with oxy-hoods the water has to be heated
- --The cold will compromise them if you use unheated humidification in artificial airways
37
Pulse Oxemitry
Can be delegated to the unlicensed personal
| unlicensed personal must report readings <90 %
38
Pulse Oxemitry
not reliable in shock cases or cardiac arrest
39
Pulse Oximetry
- --Noninvasive method of arterial O2 saturation that reflects the percentage of Hgb bound with oxygen in the arteries
- --Normal levels is over 90%
- --O2 saturation is reliable
40
Indications for Pulse Oximetry are:
- --Respiratory Disease
- --Patient on ventilation
- --Chest Pain
- --Activity Intolerance
- --Post op client
- --Patient going through conscious sedation
- --Patient with trauma to the chest
- --Patient with changes in oxygenation
41
Placement to read pulse ox
- --Probe may be placed on the finger
- --Toes
- --nose
- --earlobe
- --forehead
- --Palm of hands and feet for infants or children
42
pulse ox Cautions
- --Moisture - dry the skin
- --Dark nail polish
- --Poor circulation - check capillary refill
- --Skin with darker pigment may result in a false high reading
- --Any interference with light transmission and reduction of arterial pulsation can also interfere with readings
