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Rcp 100 exam 2 Flashcards

oxygen

1
Q

Hyperoxia

A

-2-3 ata and up to 7 ata
- vasoconstriction and small decrease in CO
- can reduce edema and tissue swelling in burns, cerebral edema, and crush injuries while maintaining oxygenation
- can aid in neovascularization (formation of new capillary beds) for tissue repair

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2
Q

late hypoxemia

A
  • low pH
    -high PaCO2
    -low Pao2
    -hypoventilating due to decreased respiratory drive
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3
Q

early hypoxemia

A

-high pH
-low PaCO2
-low PaO2
-hyperventilating due to decreased oxygen

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4
Q

oxygen-induced hypoventilation

A

-seen in COPD pts with CO2 retention
-can suppress hypoxic drive
-CO2 increase
-target PaO2 is 60 (Spo2 90%)

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5
Q

absorption atelectasis

A

-alveolar collapse (shunt) due to a decrease in body nitrogen because of too much oxygen (oxygen replaces nitrogen and causes atelectasis)

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6
Q

effects of oxygen toxicity

A

-vasoconstriction
-decreased CO
-decreased perfusion to the body
-thickened a-c membrane (shunt)

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7
Q

oxygen toxicity

A

-overproduction of oxygen free radicals
-caused by too much oxygen over an extended length of time
-PaO2 greater than 150

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8
Q

pulmonary dead space

A

-normal alveolar ventilation, poor blood perfusion
- anatomical and alveolar

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9
Q

shunt

A

-normal blood perfusion, poor alveolar ventilation
-anatomical and capillary

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10
Q

shunt causes

A

pneumonia, pulmonary edema, tissue trauma, atelectasis, mucus plugging

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11
Q

pulmonary dead space causes

A

cardiovascular shock, emphysema

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12
Q

v/q ratio

A

-ventilation to perfusion ratio
- normal is 0.8 mL (4mL/5mL)

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13
Q

alveolar ventilation (va)

A

VA=(VT-VD) x F

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14
Q

causes of hypoxemia

A

-hypoventilation (high PaCO2)
-diffusion block (thickening of alveolar-capillary membrane)
-V/Q mismatch

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15
Q

Pb

A

760 mm Hg at sea level

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16
Q

PH2O

A

47

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17
Q

PaCO2

A

from ABG

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18
Q

A-aDO2

A

-difference between alveolar and arterial oxygen
-A-aDO2=PAO2-PaO2
-normal is 2-10 torr
-low is good
-high is bad

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19
Q

cylinder safety

A

-oxygen is a fire hazard
-keep liquids away from oxygen
-labeled
-valve is fully closed
-never drop cylinders
-secure cylinders
-use dollies when lifting

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20
Q

Thorpe tubes

A

-pressured uncompensated: some ventilators and anesthesia machines
-pressured compensated: prevents change in downstream resistance, back pressure, most of them are these

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21
Q

Piss

A

pin-index safety system

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22
Q

Diss

A

diameter index safety system

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23
Q

Tiss

A

thread index safety system

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24
Q

Department of Transportation

A

responsible for construction standards

25
Q

National Fire Protection Agency

A

sets standards for storing medical gases

26
Q

Food and Drug Administration

A

determines purity standards and labeling

27
Q

Compressed Gas Association

A

sets safety standards by making recommendations

28
Q

High flow nasal cannula

A

-loss of muscle tone
-#cause of sleep apnea
-obstruction caused by tongue
-loss of consciousness
-central nervous system depression
-drugs

29
Q

advantages of LVN

A

-controlled FiO2
-humidification
-optional heat (heater donut)

30
Q

indications for LVN

A

-trach patient (not ventilated)
-trach mask
-t-piece
-oxyhood (for babies)
-face tent

31
Q

Large volume nebulizers (lvn)

A

-bland aerosol setup
-wet set
-trach setup

32
Q

magic box

A

-air:o2 ratio
-entrainment devices(venturi mask, lvn, jet nebulizer)

33
Q

patient inspiratory demand (flow)

A

=Ve x 3
(Ve=Vtxf)

34
Q

device total flow

A

=(air:O2) x flow rate

35
Q

venturi mask-Bernouli’s principle

A

-the amount of air entrained varies directly with the size of the port and velocity of O2 at the jet
-velocity of a substance- gas moving through a tube at a constant flow is indirectly to the diameter of the tube. (the smaller the tube, the faster the velocity)

36
Q

venturi mask

A

-air-entrainment mask
-flow varies; should provide output flow more than 60 lpm
-O2 range: 24-50 %
-best for pts in unstable condition who need precise low FiO2
- the higher the FiO2 the lower the total flow

37
Q

Calculating FiO2

A

FiO2= 21 or 20 + (4 x liter flow)

38
Q

high flow devices

A

deliver more total flow than a patient’s inspiratory demand

39
Q

nasal cannula

A

-up to 6 lpm
-variable oxygen stability
-for pts in stable condition who need low FiO2
-easy to use, disposable, low cost
-O2 range: 22-40%
-low flow

40
Q

non-rebreather mask

A

-minimum of 10 lpm (always flush)\
-O2 range: 60-80%
-best for emergencies; short term therapy requiring high FiO2
-low flow

41
Q

low flow devices

A

deliver less than the total flow than a patient’s inspiratory demand

42
Q

alveolar gas equation (PAO2)

A

-PAO2=(Patm-PH2O) x FiO2 - (PaCO2/RQ)
or
-PAO2=(Patm-PH2O) x FiO2 - (PaCO2x1.25)
-Patm or Pb is 760
-PH2O is 47

43
Q

PAO2

A

partial pressure of alveolar pressure

44
Q

room air

A

21% oxygen

45
Q

high flow devices

A

-venturi mask
-high flow nasal cannula
-cpap
-bipap
-ventilator

46
Q

low flow devices

A

-nasal cannula
-simple mask
-partial rebreather mask
-non rebreather mask
-face tent

47
Q

examples of ischemic/circulatory hypoxia

A

-shock
-coronary artery disease
-peripheral vascular disease
-heart attack

48
Q

ischemic/circulatory hypoxia

A

-low blood flow
-low CO
-low preload
-low contractility
-increased afterload

49
Q

histotoxic hypoxia (cellular hypoxia)

A

-dysoxia: inadequate tissue oxygenated
-normal PaO2 and hemoglobin
-inability of mitochondria to metabolize O2
-severe acidema (low pH)
-severe alkalemia (high pH)

50
Q

examples of histotoxic hypoxia

A

-cyanide poisoning
-carbon monoxide (CO) poisoning

51
Q

Cardiac output

A

-CO
-heart rate x stoke volumee

52
Q

examples of anemic hypoxia

A

-carbon monoxide (CO) poisoning
-trauma (bleeding)
-malnutrition
-iron deficiency
-B12 deficiency bone marrow problems

53
Q

anemic hypoxia

A

-normal PaO2
-reduced Hb to carry oxygen to tissues
-blood loss (and therefore oxygen loss)
-reduced blood content of arterial blood (CaO2)
-CaO2=(hb x 1.34)(SaO2/100)+(PaO2x0.003)

54
Q

4 points of partial pressure

A

-atmosphere
-airway
-alveoli
-artery

55
Q

hypoxic hypoxia

A

-low arterial PO2 (PaO2)
-low atmospheric O2
-inadequate alveolar ventilation
-insufficient O2 diffusion through capillaries
-less hemoglobin (Hb) is converted to oxy-hemoglobin
-low A-aDO2

56
Q

causes of hypoxic hypoxia

A

-high altitude
-fluid in lungs (pulmonary edema)
-airway obstruction
-lung disease (COPD, pulmonary fibrosis,etc)

57
Q

4 types of hypoxia

A

-anemic
-hypoxic
-ischemic/circulatory
-histotoxic/tissue

58
Q

hypoxia

A

cellular deficiency of oxygen

59
Q

oxygen indications

A

-hypoxia (4 types)
-tachypnea (fast breathing)
-cyanosis (blue, low O2)
-disorientation(confused)
-cardiac arrhythmias
-tachycardia (fast heartbeat)
-labored breathing (increased wob)
-pre-surgery
-anemia
-carbon monoxide poisoning
-high altitude

rcp (3 decks)

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