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Patient Management 2 > Oxygen Therapy and Administration & Airway Suction > Flashcards

Oxygen Therapy and Administration & Airway Suction Flashcards

1
Q

T/F

Oxygen is colorless, odorless and tasteless.

A

True

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2
Q

What percentage of oxygen contributes to atmospheric gases?

A

21%

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3
Q

Is oxygen flammable?

A

Not flammable but, supports combustion

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4
Q

What is critical for efficient cellular metabolism?

A

Oxygen

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5
Q

T/F

Only oxygen is carried in hemoglobin.

A

Fals; Both oxygen and carbon dioxide are carried in combination with hemoglobin

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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.

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7
Q

Define hypoxemia:

A

Abnormally low levels of oxygen in the blood

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8
Q

Define hypoxia:

A

Inadequate oxygen supply at the tissue/cellular level

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9
Q

How long can the human brain survive without adequate supply to oxygen?

A

No more than 6 minutes

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10
Q

What organs are most sensitive to hypoxia?

A

Liver, heart and lungs

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11
Q

What does Hypoxemia lead to?

A

Hypoxia

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12
Q

T/F

Hypoxemia and hypoxia are medical emergencies.

A

True

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13
Q

What are th 2 main goals of oxygen therapy?

A
  1. aintain adequate tissue oxygenation.
  2. Minimize increased cardiopulmonary workload associated with hypoxia/hypoxemia.
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14
Q

What is meant by increased cardiopulmonary workload?

A

Increased heart rate, BP & respiratory rates

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15
Q

T/F

Oxygen is a drug

A

True

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16
Q

What are the clinical indications for oxygen administration?

A

To correct hypoxemia and possible tissue hypoxia.

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17
Q

T/F

Oxygen must be prescribed/ordered.

A

True

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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

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19
Q

What is partial pressure?

A

It is the amount of pressure a particular gas contributes to the total pressure

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20
Q

How is the partial pressure of oxygen written?

A

PaO2

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21
Q

What is another term for the partial pressure of oxygen?

A

Oxygen tension

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22
Q

How is the partial pressure of carbon dioxide written?

A

PaCO2

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23
Q

Why would carbon dioxide start accumulating within the bloodstream?

A

Suffocation, drowning, (any situation where a patient cannot take in proper oxygen)

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24
Q

What determines the pH of the blood?

A

Hydrogen ions

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25
Q

Will Carbon dioxide make the blood more or less acidic?

A

More acidic

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26
Q

How is prevention of excessive acidity of blood is achieved?

A

Through a buffer; bicarbonate (HCO3−)

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27
Q

This pathologyis a serious electrolyte disorder characterized by an imbalance in the body’s acid-base balance. What pathology is this?

A

Metabolic acidosis

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28
Q

What can metabolic acidosis lead to?

A

A drop in bicarbonate which can cause Respiratory acidosis

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29
Q

T/F

Hyperventilation leads to poor expelling of carbon dioxide.

A

False; Hypoventilation leads to poor expelling of carbon dioxide.

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30
Q

What is an abormal increase of carbon dioxide known as?

A

Hypercapnia

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31
Q

What does ABG stand for?

A

Arterial Blood Gases

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32
Q

How is the effectiveness of pulmonary function is most accurately measured?

A

Testing of arterial blood for the concentration of oxygen, carbon dioxide, HCO3-, acidity and the saturation of hemoglobin with oxygen (SaO2).

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33
Q

T/F

Blood at its baseline is slightly basic

A

True

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34
Q

What is the normal pH of blood?

A

7.35 – 7.45

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35
Q

What is the normal PaCO2 in the body?

A

35 – 45mm Hg

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36
Q

What is the normal PaO2 in the body?

A

75 – 100mm Hg

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37
Q

What is the normal HCO3 (bicarbonate) concentration in the body?

A

22 – 30 mmol/L

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38
Q

What is the normal SaO2 in the body?

A

95 - 100%

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39
Q

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.

A

True

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40
Q

What does FiO2 stand for?

A

Volumetric fraction of Inspired Oxygen

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41
Q

What is the FiO2 of oxygen in atmospheric air?

A

0.21

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42
Q

What is the highest FiO2?

A

1

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43
Q

What is the FiO2 typically maintained at for most patients on mechanical ventilation? Why?

A

Typically maintained below 0.5 even with mechanical ventilation, to avoidoxygen toxicity.

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44
Q

T/F

Drug concentration is prescribed in % or in FiO2.

A

True

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45
Q

What is the ratio ofpartial pressure arterial oxygen and fraction of inspired oxygen, known as?

A

Horowitz indexorCarrico index

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46
Q

What is the Horowitz indexorCarrico index comparing?

A

Comparing the oxygen level in the blood and the oxygen concentration that is breathed

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47
Q

What is the purpose of the Horowitz indexorCarrico index ratio?

A

This helps to determine the degree of any problems with how the lungs transfer oxygen to the blood

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48
Q

What is the normal amount of breaths per minute in an adult?

A

15 – 20

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49
Q

What is the normal amount of breaths per minute in a child (1-10)

A

20 – 30

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50
Q

What is the normal amount of breaths per minute in an infant? (under 1 year)

A

30 – 60

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51
Q

What is the purpose of Pulse oximeters?

A

It is used to monitor the oxygen saturation of hemoglobin.

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52
Q

Where is the sensor of a pulse oximiter placed?

A

On the finger or the earlobe

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53
Q

What part of the pulse oximeter distinguishes between oxygenated and deoxygenated blood?

A

The photodetector attached to the sensor

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54
Q

What device is being shown here?

A

A wireless pulse oximeter

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55
Q

What device is being shown here?

A

A pulse oximeter

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56
Q

What is the most accurate way to obtain concentrations of gases in the blood?

A

Through ABG blood tests

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57
Q

Where are the places on the body that blood is drawn to obtain ABG measurements?

A
  1. Radial artery at the wrist
  2. Brachial artery
  3. Femoral artery at the groin
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58
Q

Where is the most common area on the body to obtain measurements for ABG?

A

The radial artery

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59
Q

Who needs oxygen therapy?

A
  1. Any patient with impaired O2 uptake: Trauma, Shock. Sleep apnea, Acute anxiety with increased heart rate and (SOB)
60
Q

What are the diseases/ilnesses that require oxygen therapy?

A
  1. Emphysema
  2. COPD (Chronic obstructive pulmonary disease)
  3. Pneumonia
  4. Asthma
  5. Lung tumours
61
Q

How is the flow rate of oxygen measured in flow meters?

A

In liters per minute

62
Q

What is the typical flow rate in flow meters?

A

0 – 15LPM

63
Q

How does the flow meter tell you how much oxygen is present?

A

As soon as you turn on oxygen, the ball w/in the flow meter moves

64
Q

What is being shown here?

A

A flow meter

65
Q

How many pounds of pressure is contained within Portable Oxygen Delivery tanks?

A

2000lb of pressure per square inch.

66
Q

What do the 2 regulator valves on Portable Oxygen Delivery tanks indicate?

A

One indicates how much oxygen is in the tank, the other measures the rate of flow through the delivery tubing.

67
Q

What is the universal color for oxygen?

68
Q

What does the regulator within the Portable Oxygen Delivery tank consist of?

A

Regulator consisting of a flowmeter and pressure manometer.

69
Q

When magnetic resonance imaging studies are performed, what type of cylinders containing oxygen must be used?

A

Aluminum cylinders must be used.

70
Q

When should an MRT use the wall outlet instead of the portable oxygen tank for a patient?

A

If the procedure is going to take long, (over 5 min) change from the portable tank to the wall outlet.

71
Q

What are the oxygen delivery devices divided into?

A

Low and high flow delivery devices.

72
Q

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.

73
Q

T/F

A low or variable-oxygen concentration device does not meet the entire inspiratory needs of the patient.

74
Q

In low flow delivery systems, when does the percentage of oxygen that a patient receives fluctuate?

A

Fluctuates with a change in depth or respiration, respiratory rate, or breathing pattern.

75
Q

T/F

A high flow delivery system doesn’t meet the inspiratory needs of the patient when the device is functioning properly.

A

False; A high flow delivery system does meet the inspiratory needs of the patient when the device is functioning properly.

76
Q

In High Flow Delivery Systems, are room air gases mixed with oxygen before reaching the patient?

A

Yes, Room air gases are precisely mixed with 100% oxygen before reaching the patient.

77
Q

T/F

High flow delivery systems provide the patient a precise oxygen percentage or FiO2, regardless of the breathing pattern.

78
Q

What is the most common device used to deliver lower concentrations of oxygen?

A

The Nasal Cannula

79
Q

What percentage of oxygen is flowing through a nasal cannula?

A

100% oxygen flowing through the tubing

80
Q

What do both ends of a nasal cannula connect to?

A
  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
Q

How is a nasal cannula held in place?

A

Cannula is held in place by looping the tube over the patient’s ears.

82
Q

What type of patients use the nasal cannuala?

A

Used in patients that do not require rigid control of respiration.

83
Q

Is a nasal cannula a low or high flow system? Why?

A

Low flow system; because the patient inhales oxygen from the cannula as well as room air

84
Q

What is the flow rate and oxygen concentration (once it reaches the patient) for a nasal cannula for adults?

A

1 – 4LPM with a concentration of oxygen ranges from 21 - 60%.

85
Q

What is the flow rate for children with a nasal cannula?

A

1/4 to ½ of LPM for adults

86
Q

What can higher flow rates in a nasal cannula result in?

A

The drying of the nasal mucosa (and epistaxis)

87
Q

When is humidity added to a nasal cannula?

A

When the flow rate is greater than 4LPM (up to 6LMP)

88
Q

What is being shown here?

A

A canester of fluid that is used to provide humidity for nasal cannulas

89
Q

What is being shown here?

A

A nasal cannula

90
Q

Why shoud oxygen should be turned on and flowing at the desired rate before placing any low flow device on a patient?

A

This prevents a sudden burst of oxygen into the patient’s nostrils when the regulator is first turned on.

91
Q

Why are masks not tolerated as well as nasal cannulas?

A
  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
Q

T/F

Oxygen masks deliver accurate as well as high concentrations of oxygen.

93
Q

What is one medical risk assosiated with oxygen masks?

A

Increase of chance of aspiration if the patient vomits

94
Q

What are Simple Face Masks used for?

A

Short term oxygen therapy

95
Q

What are Simple Face Masks connected to?

A

Oxygen supply and flow meter or oxygen tank

96
Q

What is being shown here?

A

Simple face mask

97
Q

What is the flow rate and oxygen concentration (once it reaches the patient) of simple face masks?

A

5LPM (5-10LPM); with an oxygen concentration of 30 – 50%

98
Q

Are Non-Rebreather Masks high or low flow?

99
Q

What mask is this? Label 1 and 2:

A

Non-Rebreather Mask
1. Inhalation port
2. Exhalation port

100
Q

What is the purpose of the valves on non-rebreather masks?

A

Valves prevent rebreathing of exhaled (prevents dilution).

101
Q

Is a non rebreather face masks high or low flow

102
Q

Is a partial rebreather high or low flow

103
Q

T/F

Partial rebreather masks collects some of the exhaled air in the resivior bag.

104
Q

Why is it a benefit to have some carbon dioxide come back in to a partial rebreather mask?

A

Stimulate regular response to breathing

105
Q

How much of the exhaled air of a partial rebreather mask goes into the resivior bag?

A

Allows the first 1/3rd of the exhaled breath (which has a higher O2 concentration) to get into the reservoir bag.

106
Q

Is a nebulizer a high or low flow device?

A

High flow device

107
Q

What is the flow rate and concentration of oxygen (once it reaches the patient) for nebulizers?

A

-28 – 100%
-At least 8LPM.

108
Q

T/F

Nebulizers can be used with aerosol face masks, ETTs or tracheostomies.

109
Q

This drug delivery device is used to administer medication in the form of a mist inhaled into the lungs. What device is this?

A

A nebulizer

110
Q

How do nebulizers allow medication to be inhaled?

A

Uses oxygen to break up solutions (of medication) and suspends it into small aerosol droplets that can be directly inhaled by the patient.

111
Q

What mask is an air-entrainment mask

A

A ventouri mask

112
Q

What is the range of concentrations of oxygen for venturi masks?

A

24 – 60%

113
Q

How do venturi masks administer oxygen?

A

By mixing room air and the oxygen in specific percentages which delivers known oxygen concentration..

114
Q

Which masks are Fixed Orifice Device/Jets?

A

Venturi masks

115
Q

What is being shown here?

A

Venturi mask Fixed Orifice Device/Jets

116
Q

What mask is being shown here?

A

Venturi mask

117
Q

When are oxygen tents/hoods utilized?

A

Used when higher rate of humidity & concentration of O2 required than is present in the natural environment

118
Q

What mask is being shown here?

A

Oxygen Tent/Hood

119
Q

Should you turn off Oxygen Tents/Hoods during x-ray examinations?

A

Yes; because having electrical device inside the tent can be hazardous

120
Q

What is another name for a Transtracheal Delivery System?

A

Mechanical ventilators/respirators

121
Q

What type of patients require a Transtracheal Delivery System?

A

Persons who require continuous therapy for long periods

122
Q

T/F

Liquid oxygen lasts longer than other forms of oxygen

123
Q

T/F

One hazard of oxygen administration is depressed ventilation.

124
Q

What amount of oxygen can a healthy patient tolerate and for how long?

A

Healthy patient can tolerate 50% FiO2 for 24-48 hours.

125
Q

What can mild oxygen toxicity result in?

A

Reversible tracheobronchitis

126
Q

What can severe oxygen toxicity result in?

A

Irreversible parenchymal lung injury.

127
Q

What is COPD?

A

Chronic lung disease results in chemoreceptors that no longer respond to CO2 stimulus.

128
Q

T/F

COPD patients may requrire may require some degree of hypoxemia as a respiratory stimulus. Why or why not?

A

True; If they receive excessive oxygen, the hypoxia is no longer present and respiration ceases.

129
Q

Where is an oxygen source located?

A

In a tank or a wall

130
Q

T/F

A nasal cannula and a simple face mask are both disposable items.

131
Q

What is suctioning used for?

A

Patients who are unable to clear their throats or mouths of blood, secretions or vomit.

132
Q

Where is suctioning usually located?

A

It is ussually wall mounted

133
Q

T/F

Suctioning is discarded after each use and replaced immediately.

134
Q

What is being shown in this image? What is #1 pointing to?

A

-Suctioning device
-1 is pointing to the automatic shut off valve/bacterial filter

135
Q

What is being shown here?

A

A yankauer used for suctioning

136
Q

What are the different routes of entry that suctioning can take place through?

A

Oropharynx, nasopharynx or tracheostomy.

137
Q

What is being shown here?

A

Suctioning through a tracheostomy

138
Q

What are the contraindications to suctioning?

A
  1. Facial injuries
  2. Loose teeth, dentures, crowns
  3. Bleeding esophageal varices
  4. Recent nasal, oral or esophageal surgery
  5. Croup (laryngotracheobronchitis) .
139
Q

What is croup?

A

Swelling within trachea, severe bronchospasm, irritable airway

140
Q

Watch the following videos:

A

https://youtu.be/Sx9NC5j8yew
https://youtu.be/TzMwBWtmGbk
https://youtu.be/493GIq064TY
https://youtu.be/idL717ww3jE
https://youtu.be/8PKKTwzxG7k

141
Q

What is the ABG pressure for;

PaCO2

A

35 – 45mm Hg

142
Q

What is the ABG pressure for;

PaO2

A

75 – 100mm Hg

143
Q

What is the noraml amount of HCO3 in the blood?

A

22 – 30 mmol/L

144
Q

What is the normal SaO2

145
Q

Is adequate oxygen taking place when the ABG pressure PaO2 is below 60mm Hg?

Patient Management 2 (11 decks)

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