Unit 1: Oxygenation Review

Question 1

For every Liter of O2, we increase the FiO2 by ____

Answer 1

4

Question 2

1 L = ___% FiO2
2 L = ___% FiO2
3 L = ___% FiO2
4 L = ___% FiO2

Answer 2

1 L = 24% FiO2
2 L = 28% FiO2
3 L = 32% FiO2
4 L = 36% FiO2

Question 3

Use humidification if oxygen is being delivered at __ L/min or higher.

Answer 3

4 L

Question 4

How often should we check the skin (where?) around the nasal cannula and also clean the cannula or mask?

Answer 4

Every 4 to 8 hours
Behind the ears, back of the neck, and face

Rinse cannula or mask with warm water to prevent a build-up of condensation (if humidified) which can lead to bacterial growth

Question 5

For nasal cannula, how often should mouth care be performed?

Answer 5

q 8 hrs and as needed

Question 6

At what FiO2 % of oxygen do we worry about oxygen toxicity (hyperoxia)?

Answer 6

Continuous Oxygen level >50% FiO2 or >8 L/min for >24-48 hrs

Can cause lung injury and reduce skin integrity by producing oxygen free radicals (ROS)

Question 7

The S/S of lung injury caused by hyperoxia resembles the S/S of ____

Answer 7

Acute Respiratory Distress Syndrome (ARDS)

Question 8

Early S/S of Hyperoxia (5)

Answer 8

Dyspnea
Non-productive cough
Chest pain beneath the sternum
GI upset
Crackles in lungs

Question 9

Late S/S of Hyperoxia (5)

Answer 9

Hypoxemia
Atelectasis (not enough nitrogen, which prevents alveolar collapse)
Pulmonary edema
Hemorrhage
Hyaline membrane formation (breakdown products of alveoli)

Question 10

Oxygen delivery devices in order of least to most O2 delivered:
(exclude high-flow O2 delivery devices)

Answer 10

1. Nasal Cannula
2. Simple Facemask
3. Partial Rebreather
4. Nonrebreather

Question 11

High-flow oxygen delivery devices (3) deliver an accurate O2 concentration from __% to ___% at _ to __ L/min.

Answer 11

1. Venturi mask
2. High-flow nasal cannula (Vapotherm)
3. Tracheostomy collar

24-100% O2 at 8 to 15 L/min

(also includes: aerosol masks, face tents, and T-piece)

Question 12

Nasal Cannula is delivered at flow rates of __ to __ L/min of oxygen.

Answer 12

1 to 6 L/min (24-44% O2)

Question 13

Simple Facemasks require a minimum flow rate of __ L/min to prevent rebreathing of exhaled air and can deliver O2 concentrations of __% to __% for short-term O2 therapy.

Answer 13

5 L/min

40-60% O2

Question 14

Partial nonrebreathers deliver O2 concentrations of __% to __% with flow rates of _ to _ L/min.

What should we monitor for with this device (related to the actual O2 delivery system)?

Answer 14

60-75%
6 to 11 L/min

Make sure the bag remains slightly inflated at the end of inspiration.

Question 15

Nonrebreathers can deliver O2 concentrations >__% at a flow rate of __ L/min for short-term O2 therapy and prevent room air from entering the exhalation ports to maintain a high level of O2.

Answer 15

> 90% (~65-95%) at 15 L/min.

Question 16

When might we use a Nonrebreather?

Answer 16

Short-term O2 therapy for patients with an unstable respiratory status and may require intubation.

Question 17

High-flow nasal cannulas (HFNC/Vapotherm) can be maintained at liter flow rates of 30 to 60 L/min and are used for better _______ and _____ control along with humidification.

Answer 17

Temperature and oxygen control with humidification (minimizes mucous membrane damage and improves secretion clearance)

Question 18

______ masks deliver the most accurate oxygen concentration without intubation.

Answer 18

Venturi Masks

Question 19

Noninvasive Positive-Pressure Ventilation (NPPV) uses positive pressure to keep alveoli open and improve ___ ______. NPPVs are used to manage (5)

Answer 19

keep alveoli open and improve gas exchange.

Dyspnea, Hypercarbia, COPD exacerbations, cardiogenic pulmonary edema, and acute asthma attacks.