Test 3 Study Guide Flashcards
Temperature at which a substance no
longer can be characterized as either a liquid or a gas.
Critical temperature (TC)
The pressure required at a critical
temperature to change a gas to a liquid.
Critical pressure (PC)
Substance is the pressure and temperature at which the substance can exist in the three phases of matter in
equilibrium.
Triple Point
Compressed air is supplied in cylinders that are color coded ______.
Yellow
_______ compressed air is commonly provided in hospital medical gas systems
Piped
Smaller, ______ air compressors are available for hospital or home use.
Portable
What are the 2 therapeutic uses of room air
1) To dilute 100% oxygen
(Oxygen delivery mixed ranges 22% to 99%)
2) Driving gas for breathing devices
(Patients who do not require supplemental oxygen)
Colorless, transparent, odorless, tasteless, nonflammable gas,
only slightly heavier than air at standard temp and pressure.
O2
O2 is color coded _____.
Green
Only ___ mL of O2
dissolves in 1 L of water at standard temp and pressure
10.2 mL
______ can be liquefied when its temperature is lowered to (–
297.3°F),(–182.9°C).
Gaseous O2
Liquid O2 has a pale-blue color and is ___ times heavier than water.
1.1
Avoid use of ____ products around oxygen
Petroleum (Support of combustion)
Oxygen concentrators concentrate oxygen from ambient air by filtering out
nitrogen. This process is called ____ _____.
Molecular Filtration
Used widely in respiratory home care with O2 concentrator devices
O2 Membrane Concentrators
Color coded gray
CO2 (Carbon Dioxide)
Colorless, transparent, odorless to pungent, and tasteless or slightly acid-tasting gas with a specific gravity of 1.522 making it heavier than air.
CO2
Nonflammable and does not support combustion or animal life.
CO2
CO2 is primarily used in medicine for _____.
Calibration
CO2 is a by-product of _____ _____ and the burning of carbonaceous
fuels.
Animal Metabolism
Mixed with oxygen and used medically for its low density and ability to
reduce turbulent airflow with natural or artificial airways.
Heliox
2 mixtures for Heliox
- 80/20 mixture
- 70/30 mixture
Decreases work of breathing. May be administered via mask or mechanical ventilation.
Heliox
Indications for the use of heliox
Asthma.
* COPD.
* Croup.
* Bronchiolar cancer.
* Tracheal stenosis.
Therapeutic uses of nitric oxide
- Vasodilation, neurotransmission, long term memory, immunologic defense.
Plays important role in vascular smooth muscle relaxation, inhibition of
platelet aggregation, neurotransmission, and immune regulation.
Nitric Oxide
Important signaling messenger molecule, of physiologic functions
Nitric Oxide
Atherosclerosis, hypertension, diabetes, erectile dysfunction, immune deficiency
disease can be an indicator of:
Low Nitric Oxide levels
Nitric Oxide concentrations
Concentrations 5 to 80 ppm
Primary uses for nitric oxide
In babies for pulmonary hypertension and in adults for Acute Respiratory Distress Syndrome (controversial)
Department in charge of federal regulation of cylinder testing
DOT
Steel medical cylinders should be tested every ___ years
10 years
Aluminum medical cylinders should be tested every _____ years
5 years
Most medical gas cylinders of any size are filled to the same high
pressure of _____ to ____
2200 to 2500 psig
To decrease the possibility of inadvertent administration of the wrong
therapeutic gas, a safety system using _______, ______, and _____.
Color-Coding
Labels
Connection Devices
When cylinders of gas are used, the pressure in a full cylinder may be 2200 to 2500 psig and must be reduced to safe ____ psig working pressure.
50 psig
High pressure reducing valves, or _____, are used for cylinders
Regulators
The American Standard Compressed Gas Cylinder Outlet and Inlet Connections, referred to as the American Standard Safety System (ASSS) is responsible for these tanks
Large high pressure cylinders (larger than E) (above 200 psig).
The Pin Index Safety System (PISS) is responsible for these tanks
Small high pressure cylinders (E or smaller) (above 200 psig)
The Diameter Index Safety System (DISS) is responsible for these tanks
Low pressure connections and fittings (below 200 psig)
Green/brown tanks are for _____.
Heliox
Causes of hypoxemia
- Partial Pressure (ex. altitude)
- Pulmonary conditions caused by hypoventilation (V/Q mismatch, Right-to-left shunt, Diffusion defect)
Involves the neurologic control of ventilation
Oxygen induced hypoventilation
O2-induced hypoventilation may occur in patients who rely on their
______ drive
hypoxemic
O2-induced hypoventilation may occur in Obstructive disease patients who have adapted to long term ______
hypercarbia
Only occurs in infants
Retinopathy of prematurity
May progress to obliteration and retinal detachment.
Retinopathy of prematurity
You want PaO2 >80 mm Hg
Damage to lung tissue caused by breathing high concentrations of O2
Oxygen Toxicity
* FIO2 > 50%.
Flow restrictors are ____, fixed flow meters.
Preset
Although less accurate, are used whenever a patient application requires that the regulator not be vertical.
Bourdon gauges
Low-flow devices
Nasal cannula
* Simple mask
* Partial rebreather
* Non-rebreathing mask
The most widely used device for administering low flow oxygen.
Nasal cannula
Consists of nasal prongs and tubing, and is
made of soft pliable plastic.
Consists of nasal prongs and tubing, and is
made of soft pliable plastic.
Flow rate of nasal cannula
1 to 6 L/min
If a nasal cannula flow rate is above 4 L/min, a ____ must be attached
4 L/min
If the bag deflates
completely during
inspiration, what do you do?
Turn up the flow
Hyperbaric oxygen (HBO) therapy is indicated for treatment of:
Carbon monoxide poisoning.
* Clostridium myonecrosis (gas gangrene).
* Decompression sickness (bends.)
* Healing;
Often initiated due to patient complaints of shortness of breath.
Oxygen therapy
SYMPTOMS of hypoxia
Cognitive impairment.
* Cardiac rhythm and conduction dysfunction.
* Renal dysfunction.
Actual SIGNS of hypoxia:
High respiratory rate
* Cyanosis
* Chest pain
* Low PaO2
* Low SaO2
The gold standards for
documenting physiologic need for supplemental oxygen (2)
Arterial blood gas analysis and clinical signs
The most common form of continuously monitoring oxygen saturation.
Pulse oximetry
Benefits of high-flow nasal cannula
Reduces dead Space
Reduces rebreathing of Gas High in CO2
Decreases work of breathing.
Increases supplemental oxygen.
* Increases mucous clearance.
Increases airway conductance.
CPAP benefits
3 to 5 cm H2O with closed mouth.
* Increases mean airway pressure (MAP).
* Increases gas exchange.
High-flow oxygen should ____ any tidal volume, respiratory frequency, or inspiratory flow the patient might produce.
Exceed
Total flow of _____ is sufficient for most adults.
40 L/min
Venturi masks entrain air by the ____ principle and constant pressure-jet
mixing.
Bernoulli
This physical phenomenon is based on a rapid velocity of gas (e.g., O2) moving
through a restricted orifice.
Bernoulli principle
This action produces viscous shearing forces that create a decreased pressure
gradient (sub-atmospheric) downstream relative to the surrounding gases.
Bernoulli principle
