Oxygen Therapy and Administration & Airway Suction Flashcards
1
Q
T/F
Oxygen is colorless, odorless and tasteless.
A
True
2
Q
What percentage of oxygen contributes to atmospheric gases?
A
21%
3
Q
Is oxygen flammable?
A
Not flammable but, supports combustion
4
Q
What is critical for efficient cellular metabolism?
A
Oxygen
5
Q
T/F
Only oxygen is carried in hemoglobin.
A
Fals; Both oxygen and carbon dioxide are carried in combination with hemoglobin
6
Q
What exchange occurs in the body between CO2 and O2?
A
The respiratory system exchanges carbon dioxide circulating in blood for oxygen from the external environment.
7
Q
Define hypoxemia:
A
Abnormally low levels of oxygen in the blood
8
Q
Define hypoxia:
A
Inadequate oxygen supply at the tissue/cellular level
9
Q
How long can the human brain survive without adequate supply to oxygen?
A
No more than 6 minutes
10
Q
What organs are most sensitive to hypoxia?
A
Liver, heart and lungs
11
Q
What does Hypoxemia lead to?
A
Hypoxia
12
Q
T/F
Hypoxemia and hypoxia are medical emergencies.
A
True
13
Q
What are th 2 main goals of oxygen therapy?
A
- aintain adequate tissue oxygenation.
- Minimize increased cardiopulmonary workload associated with hypoxia/hypoxemia.
14
Q
What is meant by increased cardiopulmonary workload?
A
Increased heart rate, BP & respiratory rates
15
Q
T/F
Oxygen is a drug
A
True
16
Q
What are the clinical indications for oxygen administration?
A
To correct hypoxemia and possible tissue hypoxia.
17
Q
T/F
Oxygen must be prescribed/ordered.
A
True
18
Q
Why should the minimum dose of oxygen always be given to obtain the desired result.
A
Because oxygen produces a biologic/physiologic effec
19
Q
What is partial pressure?
A
It is the amount of pressure a particular gas contributes to the total pressure
20
Q
How is the partial pressure of oxygen written?
A
PaO2
21
Q
What is another term for the partial pressure of oxygen?
A
Oxygen tension
22
Q
How is the partial pressure of carbon dioxide written?
A
PaCO2
23
Q
Why would carbon dioxide start accumulating within the bloodstream?
A
Suffocation, drowning, (any situation where a patient cannot take in proper oxygen)
24
Q
What determines the pH of the blood?
A
Hydrogen ions
25
Will Carbon dioxide make the blood more or less acidic?
More acidic
26
How is prevention of excessive acidity of blood is achieved?
Through a buffer; bicarbonate (HCO3−)
27
This pathology is a serious electrolyte disorder characterized by an imbalance in the body’s acid-base balance. What pathology is this?
Metabolic acidosis
28
What can metabolic acidosis lead to?
A drop in bicarbonate which can cause Respiratory acidosis
29
# T/F
Hyperventilation leads to poor expelling of carbon dioxide.
False; Hypoventilation leads to poor expelling of carbon dioxide.
30
What is an abormal increase of carbon dioxide known as?
Hypercapnia
31
What does ABG stand for?
Arterial Blood Gases
32
How is the effectiveness of pulmonary function is most accurately measured?
Testing of arterial blood for the concentration of **oxygen, carbon dioxide, HCO3-, acidity** and the **saturation of hemoglobin with oxygen (SaO2).**
33
# T/F
Blood at its baseline is slightly basic
True
34
What is the normal pH of blood?
7.35 – 7.45
35
What is the normal PaCO2 in the body?
35 – 45mm Hg
36
What is the normal PaO2 in the body?
75 – 100mm Hg
37
What is the normal HCO3 (bicarbonate) concentration in the body?
22 – 30 mmol/L
38
What is the normal SaO2 in the body?
95 - 100%
39
# T/F
When PaO2 is below 60mm Hg or the hemoglobin saturation is below 90%, it can be assumed that the adequate oxygenation of blood is not taking place.
True
40
What does FiO2 stand for?
Volumetric fraction of Inspired Oxygen
41
What is the FiO2 of oxygen in atmospheric air?
0.21
42
What is the highest FiO2?
1
43
What is the FiO2 typically maintained at for most patients on mechanical ventilation? Why?
Typically maintained below 0.5 even with mechanical ventilation, to avoid oxygen toxicity.
44
# T/F
Drug concentration is prescribed in % or in FiO2.
True
45
What is the ratio of partial pressure arterial oxygen and fraction of inspired oxygen, known as?
Horowitz index or Carrico index
46
What is the Horowitz index or Carrico index comparing?
Comparing the oxygen level in the blood and the oxygen concentration that is breathed
47
What is the purpose of the Horowitz index or Carrico index ratio?
This helps to determine the degree of any problems with how the lungs transfer oxygen to the blood
48
What is the normal amount of breaths per minute in an adult?
15 – 20
49
What is the normal amount of breaths per minute in a child (1-10)
20 – 30
50
What is the normal amount of breaths per minute in an infant? (under 1 year)
30 – 60
51
What is the purpose of Pulse oximeters?
It is used to monitor the oxygen saturation of hemoglobin.
52
Where is the sensor of a pulse oximiter placed?
On the finger or the earlobe
53
What part of the pulse oximeter distinguishes between oxygenated and deoxygenated blood?
The photodetector attached to the sensor
54
What device is being shown here?
A wireless pulse oximeter
55
What device is being shown here?
A pulse oximeter
56
What is the most accurate way to obtain concentrations of gases in the blood?
Through ABG blood tests
57
Where are the places on the body that blood is drawn to obtain ABG measurements?
1. Radial artery at the wrist
2. Brachial artery
3. Femoral artery at the groin
58
Where is the most common area on the body to obtain measurements for ABG?
The radial artery
59
Who needs oxygen therapy?
1. Any patient with impaired O2 uptake: Trauma, Shock. Sleep apnea, Acute anxiety with increased heart rate and (SOB)
60
What are the diseases/ilnesses that require oxygen therapy?
1. Emphysema
2. COPD (Chronic obstructive pulmonary disease)
3. Pneumonia
4. Asthma
5. Lung tumours
61
How is the flow rate of oxygen measured in flow meters?
In liters per minute
62
**What is the typical flow rate in flow meters?**
0 – 15LPM
63
How does the flow meter tell you how much oxygen is present?
As soon as you turn on oxygen, the ball w/in the flow meter moves
64
What is being shown here?
A flow meter
65
How many pounds of pressure is contained within Portable Oxygen Delivery tanks?
2000lb of pressure per square inch.
66
What do the 2 regulator valves on Portable Oxygen Delivery tanks indicate?
One indicates **how much oxygen is in the tank**, the other **measures the rate of flow** through the delivery tubing.
67
What is the universal color for oxygen?
Green
68
What does the regulator within the Portable Oxygen Delivery tank consist of?
Regulator consisting of a flowmeter and pressure manometer.
69
When magnetic resonance imaging studies are performed, what type of cylinders containing oxygen must be used?
Aluminum cylinders must be used.
70
When should an MRT use the wall outlet instead of the portable oxygen tank for a patient?
If the procedure is going to take long, (over 5 min) change from the portable tank to the wall outlet.
71
What are the oxygen delivery devices divided into?
Low and high flow delivery devices.
72
Is this a high or a low flow delivery system?: An unknown amount of room air is entrained through the nose or mouth and mixes with the constant amount of 100% oxygen administered.
Low flow
73
# T/F
A low or variable-oxygen concentration device does not meet the entire inspiratory needs of the patient.
True
74
In low flow delivery systems, when does the percentage of oxygen that a patient receives fluctuate?
Fluctuates with a change in depth or respiration, respiratory rate, or breathing pattern.
75
# T/F
A high flow delivery system doesn't meet the inspiratory needs of the patient when the device is functioning properly.
False; A high flow delivery system does meet the inspiratory needs of the patient when the device is functioning properly.
76
In High Flow Delivery Systems, are room air gases mixed with oxygen before reaching the patient?
Yes, Room air gases are precisely mixed with 100% oxygen before reaching the patient.
77
# T/F
High flow delivery systems provide the patient a precise oxygen percentage or FiO2, regardless of the breathing pattern.
True
78
What is the most common device used to deliver lower concentrations of oxygen?
The Nasal Cannula
79
**What percentage of oxygen is flowing through a nasal cannula?**
100% oxygen flowing through the tubing
80
What do both ends of a nasal cannula connect to?
1. Two hollow plastic prongs deliver oxygen by insertion into the external nares
2. The other end is attached to an oxygen supply that has a flow meter attached
81
How is a nasal cannula held in place?
Cannula is held in place by looping the tube over the patient’s ears.
82
What type of patients use the nasal cannuala?
Used in patients that do not require rigid control of respiration.
83
Is a nasal cannula a low or high flow system? Why?
Low flow system; because the patient inhales oxygen from the cannula as well as room air
84
**What is the flow rate and oxygen concentration (once it reaches the patient) for a nasal cannula for adults?**
1 – 4LPM with a concentration of oxygen ranges from 21 - 60%.
85
**What is the flow rate for children with a nasal cannula?**
1/4 to ½ of LPM for adults
86
What can higher flow rates in a nasal cannula result in?
The drying of the nasal mucosa (and epistaxis)
87
When is humidity added to a nasal cannula?
When the flow rate is greater than 4LPM (up to 6LMP)
88
What is being shown here?
A canester of fluid that is used to provide humidity for nasal cannulas
89
What is being shown here?
A nasal cannula
90
Why shoud oxygen should be turned on and flowing at the desired rate before placing any low flow device on a patient?
This prevents a sudden burst of oxygen into the patient’s nostrils when the regulator is first turned on.
91
Why are masks not tolerated as well as nasal cannulas?
1. They are hot and can stick to a patients face
2. They need to be removed for eating
3. They can muffle speech
92
# T/F
Oxygen masks deliver accurate as well as high concentrations of oxygen.
True
93
What is one medical risk assosiated with oxygen masks?
Increase of chance of aspiration if the patient vomits
94
What are Simple Face Masks used for?
Short term oxygen therapy
95
What are Simple Face Masks connected to?
Oxygen supply and flow meter or oxygen tank
96
What is being shown here?
Simple face mask
97
**What is the flow rate and oxygen concentration (once it reaches the patient) of simple face masks?**
5LPM (5-10LPM); with an oxygen concentration of 30 – 50%
98
**Are Non-Rebreather Masks high or low flow?**
High flow
99
What mask is this? Label 1 and 2:
Non-Rebreather Mask
1. Inhalation port
2. Exhalation port
100
What is the purpose of the valves on non-rebreather masks?
Valves prevent rebreathing of exhaled (prevents dilution).
101
Is a non rebreather face masks high or low flow
High flow
102
Is a partial rebreather high or low flow
Low flow
103
# T/F
Partial rebreather masks collects some of the exhaled air in the resivior bag.
True
104
Why is it a benefit to have some carbon dioxide come back in to a partial rebreather mask?
Stimulate regular response to breathing
105
How much of the exhaled air of a partial rebreather mask goes into the resivior bag?
Allows the first 1/3rd of the exhaled breath (which has a higher O2 concentration) to get into the reservoir bag.
106
**Is a nebulizer a high or low flow device?**
High flow device
107
What is the flow rate and concentration of oxygen (once it reaches the patient) for nebulizers?
-28 – 100%
-At least 8LPM.
108
# T/F
Nebulizers can be used with aerosol face masks, ETTs or tracheostomies.
True
109
This drug delivery device is used to administer medication in the form of a mist inhaled into the lungs. What device is this?
A nebulizer
110
How do nebulizers allow medication to be inhaled?
Uses oxygen to break up solutions (of medication) and suspends it into small aerosol droplets that can be directly inhaled by the patient.
111
What mask is an air-entrainment mask
A ventouri mask
112
What is the range of concentrations of oxygen for venturi masks?
24 – 60%
113
How do venturi masks administer oxygen?
By mixing room air and the oxygen in specific percentages which delivers known oxygen concentration..
114
Which masks are Fixed Orifice Device/Jets?
Venturi masks
115
What is being shown here?
Venturi mask Fixed Orifice Device/Jets
116
What mask is being shown here?
Venturi mask
117
When are oxygen tents/hoods utilized?
Used when higher rate of humidity & concentration of O2 required than is present in the natural environment
118
What mask is being shown here?
Oxygen Tent/Hood
119
Should you turn off Oxygen Tents/Hoods during x-ray examinations?
Yes; because having electrical device inside the tent can be hazardous
120
What is another name for a Transtracheal Delivery System?
Mechanical ventilators/respirators
121
What type of patients require a Transtracheal Delivery System?
Persons who require continuous therapy for long periods
122
# T/F
Liquid oxygen lasts longer than other forms of oxygen
True
123
# T/F
One hazard of oxygen administration is depressed ventilation.
True
124
What amount of oxygen can a healthy patient tolerate and for how long?
Healthy patient can tolerate 50% FiO2 for 24-48 hours.
125
What can mild oxygen toxicity result in?
Reversible tracheobronchitis
126
What can severe oxygen toxicity result in?
Irreversible parenchymal lung injury.
127
What is COPD?
Chronic lung disease results in chemoreceptors that no longer respond to CO2 stimulus.
128
# T/F
COPD patients may requrire may require some degree of hypoxemia as a respiratory stimulus. Why or why not?
True; If they receive excessive oxygen, the hypoxia is no longer present and respiration ceases.
129
Where is an oxygen source located?
In a tank or a wall
130
# T/F
A nasal cannula and a simple face mask are both disposable items.
True
131
What is suctioning used for?
Patients who are unable to clear their throats or mouths of blood, secretions or vomit.
132
Where is suctioning usually located?
It is ussually wall mounted
133
# T/F
Suctioning is discarded after each use and replaced immediately.
True
134
What is being shown in this image? What is #1 pointing to?
-Suctioning device
-1 is pointing to the automatic shut off valve/bacterial filter
135
What is being shown here?
A yankauer used for suctioning
136
What are the different routes of entry that suctioning can take place through?
Oropharynx, nasopharynx or tracheostomy.
137
What is being shown here?
Suctioning through a tracheostomy
138
What are the contraindications to suctioning?
1. Facial injuries
2. Loose teeth, dentures, crowns
3. Bleeding esophageal varices
4. Recent nasal, oral or esophageal surgery
5. Croup (laryngotracheobronchitis) .
139
What is croup?
Swelling within trachea, severe bronchospasm, irritable airway
140
Watch the following videos:
https://youtu.be/Sx9NC5j8yew
https://youtu.be/TzMwBWtmGbk
https://youtu.be/493GIq064TY
https://youtu.be/idL717ww3jE
https://youtu.be/8PKKTwzxG7k
141
# What is the ABG pressure for;
PaCO2
35 – 45mm Hg
142
# What is the ABG pressure for;
PaO2
75 – 100mm Hg
143
What is the noraml amount of HCO3 in the blood?
22 – 30 mmol/L
144
What is the normal SaO2
95-100%
145
Is adequate oxygen taking place when the ABG pressure PaO2 is below 60mm Hg?
No
