Respiratory Distress & Oxygen Flashcards
1
Q
Indications of respiratory distress
A
- Increased respiratory rate
- Nasal flaring
- Intercostal & sternal retractions
- Visible expression of distress
- Increased use of neck accessory muscles
- Paradoxical breathing
2
Q
Causes of tachypnea & bradypnea
A
- Tachypnea: exercise, atelectasis, fever, hypoxemia, anxiety, pain
- Bradypnea: head injuries, sedation, drug overdose
3
Q
Describe low flow O2
A
- Variable O2 concentration
- Does not meet the entire inspiratory flow demands resulting in the entrainment of ambient air
- FiO2 can vary depending on respiratory drive & breathing pattern
- Less than 4 LPM generally do not need humidification
4
Q
Describe high flow O2
A
- Fixed O2 concentration
- Minimizes variability in FiO2 & meets the inspiratory flow demands of the patient
5
Q
Types of oxygen delivery devices
A
- Simple mask
- Aerosol mask
- Venturi mask
- Partial non-rebreather
- Non-rebreather mask
6
Q
Benefits and barriers to a nasal cannula
A
- Benefits: raises PaO2 to decrease hypoxia, allows for eating/drinking/speaking, convent use
- Barriers: dries nasal passages, narrow range of adjustment if pt becomes increasingly hypoxic
7
Q
Describe the use of a reservoir/Oximyzer
A
- Stores O2 during exhalation & allows for greater O2 to be inhaled with a lower flow rate
- Allows for portability & conservation of O2 supply when ambulatory/exercising
- May by in the facial area
8
Q
Benefits of face masks
A
- Inexpensive
- Allows for higher O2 concentration, 5-8 LPM and 40% to 60% respectively
- Raises PaO2 to decrease hypoxia
- Can be used for mouth breathers or for those with nasopharynx obstructions (polyps, etc.)
- Usually used for short duration such as post-operatively previously (now being used more frequently with therapy)
9
Q
Barriers for face masks
A
- Does not allow patient to eat, drink or easily communicate
- Ill-fitting, uncomfortable
- Can block vomitus
10
Q
Describe the differences b/w a nasal cannula and a “cool” high flow nasal cannula (HFNC)
A
- NC: flow rates b/w 1-6 L/min for adults
- HFNC: dosage 6-15 LPM (liters per min), alternative to face O2, MUST be humidified via a rigid bubbler/humidification canister
11
Q
Describe a venturi mask
A
- Can be converted to fit a trash collar to also allow those pts with a trash to mobilize easier
- O2 delivered through tubing into mask (not closed system), mixes with room air
- Max FiO2 that can be delivered is 55-60% FiO2
12
Q
Describe a non-rebreather mask (NRM)
A
- Used when mobilizing pts in acute care w/ high O2 requirements
- Use in pts with low ABG’s
- MUST set up appropriately or will entrain CO2, can run at 10-25 LPM
13
Q
Pros of a NRB
A
- Fast delivery of high concentration of O2. Sources vary in actual O2 delivered (60-100%)
- Patients otherwise tethered to wall O2 supply become able to work on ambulation trials.
- Allows inhalation of high concentration of O2 from the reservoir bag and prevents re-inhalation of just-exhaled air, thus keeping the concentration of inhaled O2 consistently high.
14
Q
Cons to use a NRB
A
- Malfunctions of apparatus can lead to suffocation > STAY WITH THE PATIENT AT ALL TIMES
- Chronic CO2 retainers – these pts live at low o2 sat readings, <90% often around 85-90%. Their respiratory drive is maintained by higher CO2 levels, which if decreased, will in turn decrease respiratory drive and function
- Facial fractures and injuries > mask will not fit well
- Agitated pts > the mask must stay in place to be effective
15
Q
Describe heated high flow nasal cannula (AKA Aquinox)
A
- Because it is directly connected to the wall inlet there is no mixing with outside air
- Assists with improved gas exchange by saturating the dead space in the airway with higher oxygen concentrations
- Due to the high flow rates you can get a CPAP (continuous positive airway pressure) effect which helps to decrease atelectasis, improved perfusion and decreases work of breathing
16
Q
Pros of HHFNC
A
- Delivers a very accurate amount of FiO2 to the patient
- Humidified oxygen can assist with patient comfort as well as assist with preventing mucous plugging
- Allows patient to be able to eat/interact easier vs. BiPAP and other forms of facemasks
- Decreases patients work of breathing
- Can assist with avoiding more invasive ventilation if utilized early