Oxygen therapy

Question 1

whats oxidative phosphorylation

Answer 1

gluxose+O2= CO2+ H2O+ 38 ATP

Question 2

whats anoxia

Answer 2

no oxygen availability in tissues

Question 3

whats hypoxia

Answer 3

low/lack of oxygen available in tissues

Question 4

what is hypoxemia

Answer 4

low/lack of oxygen in the blood

Question 5

whats FiO2

Answer 5

its the fraction of O2 in inspired gas -21%

Question 6

what are FiO2 at different litres

Answer 6

1 L/min- 24%
2 L/min- 28%
3 L/min- 32%
4 L/min- 36%
5 L/min- 40%
6 L/min- 44%

Question 7

what is oxygen therapy

Answer 7

its the administration of oxygen at concs greater than that in the RA to treat/prevent hypoxia

Question 8

is oxygen a drug

Answer 8

yes

Question 9

when should oxygen be prescribed

Answer 9

in all situations except for the immediate management of critical illness in accordance with BTS guidelines

Question 10

what happens if oxygen is abused

Answer 10

can causes complications because of ROS-ALI,ARDS,pulmonary edema

Question 11

what are the types of hypoxia

Answer 11

hypoxic hypoxia
anemic hypoxia
stagnant hypoxia
histotoxic hypoxia

Question 12

what causes hypoxic hypoxia

Answer 12

O2 poor air, hypoxic gas mixture
high altitude
hypoventilations
shunts-septal defects
diffusion defects-pneumonia, lobar collapse

Question 13

what is anemic hypoxia

Answer 13

when oxygen carrying capacity of blood is decreased

Question 14

what causes anemic hypoxia

Answer 14

anemia
altered hemoglobin- CO poisoning

Question 15

whats stagnant hypoxia

Answer 15

its when there is inadequate tissue perfusion

Question 16

what can cause stagnant hypoxia

Answer 16

generalized :
-hypovolemia
-mitral stenosis
-constrictive pericarditis
-myocardial ischemia

localized hypo perfusion:
-arterial obstruction, thrombus, edema

Question 17

whats histotoxic hypoxia

Answer 17

its when cells can not utilize the oxygen- the electron transfer system of cytochrome oxidase is paralyzed e.g. cyanide poisoning

Question 18

what are the benefits of O2 therapy in hypoxia

Answer 18

hypoxic hypoxia +++
anemic hypoxia +
stagnant hypoxia +
histotoxic hypoxia -

Question 19

what are indications for O2 therapy

Answer 19

hypoxia- when PaO2 comes down to 60mmHg
normoxic hypoxia- low cardiac output state, anemia, CO poisoning
trapped gases- like obstruction, pneumoencephalus
special situations- lie anesthesia

Question 20

what is the clinical presentation of acute hypoxia

Answer 20

restlessness
disorientation, confusion
in-coordination
impaired judgment
hyperventilation air hunger
circulatory changes: tachycardic-brady

Question 21

whats the clinical presentation of chronic hypoxia

Answer 21

fatigue, drowsiness
inattentiveness
apathy
delayed reaction time

Question 22

how to measure inadequate oxygen saturation

Answer 22

arterial blood gas
pulse oximeter

Question 23

what does a low flow O2 delivery system do

Answer 23

they contribute partially to the inspired gas the client breathes

Question 24

what are examples of low flow systems

Answer 24

nasal cannula
simple mask
non rebreather mask
rebreather mask

Question 25

what does a high flow O2 delivery system do

Answer 25

they deliver specific and constant % of oxygen independent of clients breathing

Question 26

what are examples of high flow systems

Answer 26

venturi mask
trach collar
t-piece

Question 27

what are nasal cannulas like

Answer 27

-prongs protrude 1cm into nares
-used for low concs of O2, 24-44% at 1-6L/min
-pt can talk and eat with the oxygen in place

Question 28

what are some side effects of nasal cannula

Answer 28

-irritation to the nasal and pharyngeal mucosa (drying)

Question 29

what happens if oxygen flow rates are above 4L/min

Answer 29

there is variable FiO2

Question 30

how does client exhale in a simple face mask

Answer 30

through ports on sides of mask

Question 31

how much oxygen does a simple mask deliver

Answer 31

35-60% at 6-10L/min

Question 32

what should the flow in a simple mask be at least and why

Answer 32

5L/min to avoid CO2 build up and resistance to breathing

Question 33

what are some side effects of a simple mask

Answer 33

there is potential for skin breakdown due to pressure and moisture
they are uncomfortable while eating/ talking
they obstruct coughing

Question 34

how much oxygen does the rebreather mask deliver

Answer 34

up to 80% conc at 8-12L/min

Question 35

how does a rebreather bag work

Answer 35

O2 is directed into the reservoir
on inspiration gas from bag and RA are drawn
on expiration the first 1/3 of exhaled gas goes into the bag (dead space)

Question 36

what happens to the dead space gas in the rebreather mask

Answer 36

it mixes with new O2 going into the bag

Question 37

what should the bag on the rebreather mask remain like

Answer 37

at least 1/3 full during inspiration

Question 38

what is a non rebreather mask like

Answer 38

-it has 2 one way valves at the exhalation ports and bag
-Pt can only inhale from reservoir bag
-the valves prevent exhaled gas flow into reservoir bag and the valves over exhalation ports prevent air entrainment

Question 39

how much O2 does the non rebreather mask provide

Answer 39

high O2 concs of 95-100% at 10-15L/min

Question 40

what should the non rebreather mask bag remain like

Answer 40

inflated at all times

Question 41

when do you use a no rebreather mask

Answer 41

critical illness
trauma patients
post cardiac or respiratory arrest

Question 42

non rebreather masks are effective for what

Answer 42

short term treatment