Airway and Oxygenation

Question 1

why do we need oxygen?

Answer 1

• essential for life and function of cells/tissues
• respiratory, cv, hematologic systems work together providing sufficient tissue perfusion to the body
• oxygen therapy improves oxygenation and perfusion

Question 2

clinical manifestations of respiratory distress

Answer 2

• dyspnea
• nasal flaring
• use of accessory muscles to breath
• pursed lip or diaphragmatic breathing
• decreased endurance
• skin, mucous membrane changes (pallor, cyanosis)

Question 3

oxygen therapy relieves _____

Answer 3

hypoxemia

Question 4

low levels of oxygen in the blood is called _____

Answer 4

hypoxemia

Question 5

decreased tissue oxygenation is called

Answer 5

hypoxia

Question 6

normal pH levels

Answer 6

7.35-7.45

Question 7

normal PaCO2 level

Answer 7

35.0-45.0

Question 8

normal PO2 level

Answer 8

35.0-46.0

Question 9

normal HCO3 level

Answer 9

22.0-26.0

Question 10

hypercarbia

Answer 10

retention of CO2

Question 11

CO2 narcosis

Answer 11

loss of sensitivity to high levels of CO2

Question 12

low-flow oxygen delivery systems

Answer 12

does not provide enough flow to meet total oxygen and air volume

• nasal cannula
• face mask (simple, partial rebreather, non-rebreather)

Question 13

nasal cannula flow rate

Answer 13

1-6 L/min

Question 14

nasal cannula O2 concentration

Answer 14

24-44 %

Question 15

simple facemask flow rate and O2 concentration

Answer 15

> 5 L/min

40-60%

Question 16

partial rebreather mask O2 concentration and flow rate

Answer 16

60-75%

6-11 L/min

Question 17

partial rebreather mask:

Answer 17

• one-third exhaled tidal volume with each breath

- adjust flow rate to keep reservoir bad inflated

Question 18

non-rebreather mask O2 level

Answer 18

highest O2 level

can deliver FIO2 greater than 90%

Question 19

use of non-rebreather mask

Answer 19

used for unstable patients that may require intubation

-ensure valves are patent and functional

Question 20

high-flow delivery systems:

Answer 20

can deliver 24-100% at 8-15 L/min

• venturi mask
• face tent
• aerosol mask
• tracheostomy collar
• T-piece

Question 21

delivers precise O2 concentration– best source for chronic lung disease

Answer 21

venturi mask

Question 22

when using a venturi mask, switch to ______ during meal times

Answer 22

nasal cannula

Question 23

delivers FIO2 for tracheostomy, laryngectomy, ET tubes

Answer 23

T-piece

• ensures humidifier creates enough mist
• mist should be seen during inspiration and expiration

Question 24

noninvasive positive pressure ventilation (NPPV)

Answer 24

uses positive pressure to keep alveoli open, improve gas exchange without airway intubation

• BiPAP
• CPAP

Question 25

CPAP

Answer 25

delivers set positive airway pressure throughout each cycle of inhalation and exhalation

Question 26

opens collapsed alveoli

Answer 26

CPAP

Question 27

used for atelectasis after surgery or cardiac-induced pulmonary edema; sleep apnea

Answer 27

CPAP

Question 28

HFNC (high-flow nasal cannula)

Answer 28

flow rate up to 60L/min FiO2 up to 100% heated, vaporized air optiflow

Question 29

transtracheal oxygen delivery (TTO)

Answer 29

- long-term delivery of O2 directly into lungs - small flexible catheter is passed into trachea through small incision - avoids irritation that nasal prongs cause; is more comfortable - flow rates prescribed for rest, activity

Question 30

home oxygen therapy pt education:

Answer 30

- compressed gas in tank or cylinder - liquid oxygen in reservoir - oxygen concentrator

Question 31

reposition patient for optimal airway opening:

Answer 31

- head tilt-chin lift method - jaw thrust method clear airway (suction) ambu if necessary -BMV or bag-mask-valve