Oxygen Therapy

Question 1

Oxygen complications

Answer 1

• with PaO2 >or= 60 torr, ventilatory depression may occur in spontaneously breathing pt with elevated
• with FiO2 > or = 0.5, absorption atelectasis, oxygen toxicity, and/or depression of ciliary and/or leukocytic function may occur
• administer with caution paraquat poisoning and belomycin

Question 2

Oxygen precautions/complications

Answer 2

• minimal oxygen should be used during laser bronchoscopy
• fire hazard increased
• bacterial contamination associated with certain nebulization or humidification

Question 3

O2 assessment

Answer 3

Measurement of inadequate oxygen tensions or saturation

By invasive or noninvasive methods and/or presence of clinical indicators

Question 4

Assessing need of O2

Answer 4

Lab- PO2, Hg saturation

Clinical- CO poisoning, cyanide poisoning, shock, trauma, MI

Question 5

Hypoxia

Answer 5

Lack of O2 to tissues

Hypoxemic, tissue or dysoxia, circulatory, anemic, idiopathic

Question 6

Oxygen toxicity

Answer 6

PO2 and exposure time (O2 >50% no longer than 24 hrs)

• CNS- tremors, twitching, convulsions
• lung- bronchopneumonia, infiltrates, edema, fibrosis

Question 7

Depression of ventilation

Answer 7

• COPD with chronic hypercapnia

- suppression of hypoxia drive

Question 8

Retinopathy of prematurity or retrolental fibroplasia

Answer 8

Premature- low birth weight infants

Retinal vasoconstriction leading to necrosis, scarring, and detachment of the retina

Question 9

Absorption atelectasis

Answer 9

High fio2 depleting N2
O2 is absorbed
Blocked alveoli can collapse

Question 10

Low flow devices

Answer 10

Flow rates that are lower than pt inspiratory demands
Varying amounts of room air must be added
Fio2 varies depending on pt breathing
Nasal cannula, nasal cath, simple O2 mask, partial-re breathing mask, non-rebreather

Question 11

High flow devices

Answer 11

Fixed- provides all inspiratory demands for pt
Fixed fio2 regardless of breathing pattern
Air entrainment, incubator, tents, hoods, high volume aerosol - trach collars, masks, tents

Question 12

Nasal cannula

Answer 12

Most commonly used Fio2 24-40%, 1-6 Lpm

Used for- spontaneously breathing hypoxic, ER, general/critical care, COPD, exercise during pulmonary rehab, home care

Question 13

Nasal cannula hazards

Answer 13

Nasopharyngeal mucosal irritation
Twisting, knotting of tubing
Skin irritation

Question 14

3 main goals of oxygen therapy

Answer 14

Correct documented or suspected acute hypoxemia
Decrease symptoms associated with chronic hypoxemia
Decrease workload on cardiopulmonary system

Question 15

Indications for oxygen therapy (5)

Answer 15

Documented hypoxemia - PaO2<90%
Acute care where hypoxemia is suspected
Severe trauma
Acute MI
Surgical intervention -post op

Question 16

Contraindications for oxygen therapy

Answer 16

No specific contraindications exist when indications are judged to be present