Oxygen therapy

Question 1

What are the factors that will cause a Left shift in Oxyhemoglobin dissociation curve?

Answer 1

DecreasedTemp(hypothermia)
Decreased 2-3 DPG
Decreased (H+)
CO

Question 2

What are the factors that will cause a Right shift in Oxyhemoglobin dissociation curve?

Answer 2

IncreasedTemp
Increased 2-3 DPG
Increased (H+)

Question 3

What are the causes of Hypoxia?

Answer 3

Hypoxemia(resp system cant oxygenate)
Impaired Blood Flow(dec Heart)
Dysoxia(tissues cant utilize O2)

Question 4

What are the causes of Hypoxemia?

Answer 4

Low ambient PO2
Hypoventilation
Hb Deficiencies
Impaired Alveolar-Cap diffusion
V/Q Mismatch
Shunts

Question 5

What are the causes of Dysoxia?

Answer 5

Cellular use of O2 is abnormally decreased

Cyanide poisoning

Question 6

What are the causes of Normal O2 content but impaired delivery to tissues?

Answer 6

Circulatory failure(shock)
Local Reduction in perfusion
-clot
-stenosis
Ischemia
MI, Stroke

Question 7

What are the causes of Physiologic Shunt?

Answer 7

Anatomic(BF doesn’t participate in gas exchange)
-R=>L Shunt
DOESNT RESPOND TO O2 THERAPY

Alveolar Shunts(Areas of poorventilation)
-Pneumonia, COPD, atelectaisis

Question 8

What are the causesof Physiologic Dead Space?

Answer 8

Anatomical: Conducting airways
Alveolar: Inc ventilation/poorly perfused alveoli

Question 9

What are the physiologic Effects of Hypoxia?

Answer 9

Pulm vasoconstriction
Inc CV workload
Harmful effects on Myocardial Funct
Impaired renal function
Cerebral vasodilation, Inc cerebral BF
Anaerobic Mets, LA accumulation, metabolic Acidosis

Question 10

What are the CLinical Objectives in Oxygen therapy?

Answer 10

Correct Hypoxemia

(Adults/kids SaO2

Question 11

What is the pathological response to Oxygen therapy?

Answer 11

Damage Capillary Endothelium
Thickening of alveolar-cap membrane
Alveolar Exudate and Consolidation causing physiological shunting
Pulm fibrosis and HTN at end stage

Question 12

What Disease staes are caused by Oxygen tharapy?

Answer 12

O2 induced hypoventilation
Retinopathy of Prematurity
Absorptive Atelectais(N2 replaced with O2)

Question 13

What are the different forms of Oxygen monitoring?

Answer 13

Pulse Oximetry
Arterial Blood Gas
Capillary Sampling

Question 14

What are indications of Oxygen therapy?

Answer 14

Air Embolism
CO poisoning
Wound therapy

Question 15

What are the complictions of Hyperbaric O2 therapy?

Answer 15

Barotrauma caused by high pressure

CNS, Pulm complications caused by O2 toxicity

Question 16

What are the different Forms of delivery of O2 therapy?

Answer 16

Low flow systems
-nasal cannula
-simple mask
-partial/non rebreather with reservoir
High Flow Systems
-Venturi mask
-aerosol mask
Enclosures
-Tents and hoods
-Isolettes

Question 17

Waht are the Pros/Cons of Nasal Cannula?

Answer 17

Comfotable
Low cost
Mobility
Mouth breathing ok

Cant do High O2
Requires adequate vent pattern

Question 18

What are the Pros/Cons of the Simple O2 mask?

Answer 18

Overflow valves if flow rate too high
Higher inspired O2
WOnt dry Mucous membranes

Interferes with eating/talking
Irritating to face
Var FiO2

Question 19

What are the Pros/Cons of the Partial Rebreather Mask?

Answer 19

Higher FiO2
Better gas reserve

Requires tight fit
Not practical for long term therapy
Remove for eating/talking

!!! Keep reservoir filled!!!
Monitor ABG
Keep good seal

Question 20

What are the Pros/Cons of the Non-rebreather mask?

Answer 20

Good for short term
Similar to partial rebreather

Higher potential for O2 Tox

Question 21

What are the Pros/Cons of the Venturi mask?

Answer 21

Delivers exact FiO2
FiO2 independant of vent rate

Interferes with eating/talking
Condensation
Needs to fit well!

Question 22

What are the Pros/Cons of the Aerosol mask?

Answer 22

Humidification and heat
Port Can control FiO2 28%-100%

Water can build up in tubing
Heater malfunction