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Respiratory > Oxygen Therapy > Flashcards

Oxygen Therapy Flashcards

1
Q

What is ventilation?

A

Bringing in air from the environment to the lungs

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2
Q

What is diffusion?

A

Moving air from the alveoli to the capillaries

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3
Q

What are the factors that determine the amount of oxygen absorbed from the pulmonary system?

A

[Hb]
Blood volume
Circulation

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4
Q

What are the factors that determine the amount of oxygen delivered from the capillaries to the tissues?

A

Tissue oxygen use

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5
Q

What percent of oxygen is dissolved in plasma?

A

2-3%

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6
Q

What are the factors that shift the oxygen-Hb saturation curve to the left? (temp, 2,3, BPG, pH, and CO)

A

Decreased temp
Decreased 2,3 BPG
Decreased pH
Increased CO

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7
Q

What is the definition of hypoxia?

A

O2 delivery to the tissues is inadequate to meet metabolic needs

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8
Q

What is the definition of hypoxemia (arterial PO2 levels for adults and neonates)?

A
  • Arterial PO2 less than 60 mmHg

- Less than 50 mmHg for neonates

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9
Q

What is Dysoxia?

A

Impaired ability for tissues to utilize oxygen

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10
Q

What are the three major causes of hypoxia?

A
  • Hypoxemia
  • Impaired blood flow
  • Dysoxia
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11
Q

What are the two major causes of impaired alveolar-capillary diffusion?

A
  • Inadequate time for PO2 to equilibrate

- Severe thickening of the membrane

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12
Q

What is a common cause of dysoxia?

A

CN poisoning

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13
Q

What is the normal V/Q ratio in the apices? Bases?

A 
Apices = 3
Bases = less than 1
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14
Q

What is the V/Q ratio of dead spaces?

A

infinite

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15
Q

How does aging lower the V/Q ratio?

A

Lowers the elasticity of the alveoli

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16
Q

What is an anatomic shunt?

A

Right to left shunt that does not participate in gas exchange (bronchiolar capillaries)

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17
Q

Do anatomic shunts change with respiratory therapy?

A

No

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18
Q

What is the anatomic dead space?

A

Conducting airways

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19
Q

What are alveolar dead spaces? Do these respond to oxygen therapy?

A

Poorly perfused alveoli that do respond to oxygen therapy

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20
Q

What is the effect of hypoxemia on pulmonary artery pressures? What, then, is the effect of the heart?

A
  • Increases

- Increased workload of the heart

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21
Q

How does hypoxemia result in impaired renal function?

A

Decreased blood flow

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22
Q

What is the effect of hypoxemia on the cerebral blood flow?

A

Vasodilation

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23
Q

What is the normal percent of oxygen in RA?

A

21%

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24
Q

What is the major, overall goal of oxygen therapy?

A

To maintain adequate tissue oxygenation

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25
Q

What are the physiologic effects of being exposed to 100% O2 for 0-12 hours?

A
  • Tracheobronchitis

- Substernal chest pain

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26
Q

What are the physiologic effects of being exposed to 100% O2 for 12-24 hours?

A

Decreased vital capacity

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27
Q

What are the physiologic effects of being exposed to 100% O2 for 24-30 hours?

A
  • Decreased lung compliance
  • Increased P(A-a)O2
  • Decreased exercise PO2
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28
Q

What are the physiologic effects of being exposed to 100% O2 for 30-72 hours?

A

Decreasing diffusing capacity

29
Q

What are the two major organs that are primarily affected with oxygen toxicity?

A

CNS and lungs

30
Q

When is the CNS affected with oxygen therapy?

A

With oxygen therapy greater than 60% at 1 ATM

31
Q

What is the MOA of oxygen damage to the lungs and CNS?

A

Free radical generation

32
Q

What is the pathological response to oxygen toxicity?

A
  • Damage to capillary endothelium
  • Thickening of the alveolar-capillary membrane
  • Alveolar exudate and consolidation
  • Pulmonary fibrosis and HTN
33
Q

What happens to the central response to CO2 with oxygen therapy? What does this lead to?

A

Blunted response, leading to a depressed respiratory drive

34
Q

What is the MOA of retinopathy of prematurity with oxygen therapy?

A

Excessive blood oxygen levels produce retinal vasoconstriction, causing necrosis of blood vessels. This causes a proliferation of new blood vessels, which hemorrhage and damage retina further.

35
Q

What is the MOA of absorption atelectasis with oxygen therapy?

A

oxygen levels above 50% depletes both alveolar and blood nitrogen, which is the main alveolar dilator. This can cause atelectasis.

36
Q

Above what oxygen saturation level should you attempt to keep neonates above? Adults?

A 
Neonates = 88%
Adults = 90%
37
Q

How is oxygen ordered? (2)

A

L/min

Percent FiO2

38
Q

What are the clinical guidelines for oxygen therapy?

A

Give the minimum dose needed to obtain the desired result

39
Q

What are the two things that you should monitor when administering oxygen?

A
  • Oxygen saturation

- Patient response

40
Q

What is the MOA of hyperbaric oxygen therapy?

A

Increased atmospheric pressure increases partial pressure,

41
Q

What are the pressures used for hyperbaric oxygen supply?

42
Q

What are the indications of hyperbaric oxygen therapy? (3)

A
  • Air embolism
  • CO poisoning
  • Wound therapy
43
Q

What are the two major complications that can occur with hyperbaric oxygen therapy?

A
  • Barotrauma

- CNS/pulmonary complications

44
Q

What are the high flow delivery devices for oxygen therapy?

A
  • venturi mask

- aerosol mask

45
Q

What are the two enclosures that can be used to deliver oxygen?

A
  • Oxygen tents and hoods

- Isolettes

46
Q

What are the four major low flow oxygen delivery systems?

A
  • NC
  • Simple O2 mask
  • Partial rebreather
  • Non-rebreather
47
Q

What are the disadvantages to NC use?

A
  • Cannot deliver high [O2]
  • Requires adequate ventilation patterns
  • High flow rates not tolerated
48
Q

What is the major disadvantage of a nasal catheter?

A

Can direct gas into the stomach

49
Q

True or false: the flow rate and FiO2 for a nasal catheter is similar to the nasal cannula

50
Q

The flow rate with a simple oxygen mask should not go below what level? Above what

A

5 L/min

8 L/min

51
Q

What is the major downside in terms of FiO2 with a simple oxygen mask?

A

Variable FiO2

52
Q

What is the flow rate of a NC?

53
Q

What are the flow rates for a partial rebreathing mask?

A

8 or 10-12

54
Q

What are the three precautions that should be taken with administration of oxygen with a partial rebreathing mask?

A
  • Must keep reservoir filled
  • Monitor ABGs
  • Maintain good seal
55
Q

What are the flow rates that can be given with non-rebreather masks?

A

6-15 L/min

56
Q

What is the major downside of non-rebreather masks?

A

Higher potential for oxygen toxicity

57
Q

What are venturi masks?

A

High flow oxygen system that consists of a mask with an orifice, to allow for some RA to enter

58
Q

What are the two major advantages of a venturi mask?

A
  • Delivers exact FiO2

- FiO2 independent of ventilation rate

59
Q

What is the max flow rate with an aerosol mask?

60
Q

What are aerosol masks?

A

Face mask that provided humidified and heated air

61
Q

How does hyperbaric oxygen therapy treat an air embolism?

A

Decreases air bubble size

62
Q

What is an oxygen tent?

A

An enclosure that surrounds the entire body to deliver high rates of oxygen (10-12 L/min)

63
Q

What is the max FiO2 with a NC?

64
Q

Why is it important to ensure that the partial rebreather mask is 2/3 full? What level of oxygen flow will prevent this?

A

If not, then will be breathing in CO2

6-8 L/min

65
Q

When is humidified air absolutely necessary?

A

When you bypass the naso/oropharynx

66
Q

Do oxygen tents and hoods require humidified air?

67
Q

What are the three major clinical goals of oxygen therapy?

A
  • Relieve hypoxemia
  • Reduce SOB
  • Reduce cardiopulmonary workload
68
Q

What are the flow rates that can be achieved with a venturi mask?

Respiratory (34 decks)

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