ch 42

Question 1

define hypoxia

Answer 1

abnormal condition, O2 available to body cells is inadequate to meet metabolic needs
* low oxygen in tissue

Question 2

define hypoxemia

Answer 2

abnormal deficiency of O2 in arterial blood
lab value 80-100mmHg
*low oxygen in blood

Question 3

what are the clinical objectives for oxygen therapy

Answer 3

1.correct acute hypoxemia
2. decrease symptoms associated w/chronic hypoxemia
3.decrease the workload hypoxemia causes on heart and lungs

Question 4

indications for oxygen therapy

Answer 4

*documented hypoxemia
*acute care situations in which hypoxemia is suspected
*sever trauma
*acute myocardial infarction
*short term therapy or surgical intervention

Question 5

what is the PaO2 for a healthy person

Answer 5

80-100mmHg

Question 6

what is the PaO2 for a COPD person

Answer 6

55-75mmHg

Question 7

who is at risk for retinopathy

Answer 7

premature infants
PaO2>80mmHg

Question 8

what happens when exposed to 100% FiO2

Answer 8

*oxygen toxicity
*pulmonary fibrosis&hypertension
*thickening of alveolar capillary membrane

Question 9

25-30 hours of FiO2 at 100%

Answer 9

decrease lung compliance
increasing (PA-a)O2(A-aGradient)
decreasing exercising PO2

Question 10

30-72 hours of FiO2 at 100%

Answer 10

decreasing diffusing capacity

Question 11

nasal cannula

Answer 11

liter flow: 1-6liters
low flow
FiO2: 24%-44%
humidifier for 4L and above

Question 12

advantages of nasal cannula as low flow device

Answer 12

*tolerable
*comfortable for patient
*easy to use?application
*low cost
*easy disposable

Question 13

FiO2 levels of nasal cannulas

Answer 13

1L=24%
2L=28%
3L=32%
4L=36%
5L=40%
6L=44%

Question 14

when would you use a bubble humidifier

Answer 14

4L or above
used to add moisture to oxygen, dry oxygen cause irritation of nasal passage

Question 15

transtracheal catheters

Answer 15

-placed in trachea
-40-60% less O2 to achieve same PaO2 by nasal cannula
-Liter flow= 1/4- 4L
-requires maintenance & cleaning
-infections are possible

Question 16

calculate minute ventilation formula

Answer 16

MV=RR x TV divide by 1000 to get liters
minute ventilation=respiratory rate x tidal volume

Question 17

reservoir cannulas

Answer 17

-two type nasal and pendant
-liter flow=1-10L
-FiO2=24-60%
no humidification
reservoir

Question 18

partial rebreather
vs
non rebreather

Answer 18

pr- no valve, reservoir
liter flow-10-15L
lowest-10L
CO2 rebreathing
FiO2- 40-70%

non- valve, reservoir
liter flow-15L above
lowest- 10L
CO2 rebreathing
FiO2- 60-80%

Question 19

Magic Box calculation formula

Answer 19

(100 - FiO2%) / (FiO2%-20)= ratio
(ratio + 1) x liter flow= total flow

ex FiO2 is 40% and flow set is 8L
100-40=60 40-20= 20
60/20= 3L
3 + 1= 4
4 X 8= 32

Question 20

what can happen if ports are obstructed on the air-entrainment masks

Answer 20

increased FiO2, decrease total output of flow

Question 21

what are the 4 main functions of high-flow nasal cannulas

Answer 21

1. deliver high FiO2
   2.meet or exceeds patient inspiratory flow.
2. carbon dioxide washout from deadspace
   4.generates a distending positive airway pressure

Question 22

blending system

Answer 22

-provide high O2 cencentration flow
-precise control over FiO2 total flow output
-gases mixed manually or w/precision valve
-separate pressurized air&O2 sources are input

Question 23

bag-mask valve system

Answer 23

-self inflating bag& non rebreathing valve to provide 100% O2
-used in emergency/life support/critical care

Question 24

what are the 3 ‘P’ of oxygen selection

Answer 24

1. Purpose
   2.Patient consideration
2. Performance

Question 25

hyperbaric Oxygen, physiologic effects

Answer 25

theraputic use of O2 at pressures greater than 1atm effects- *bubble reductions-embolism *hyperoxygenation of blood&tissue vascocontriction *enhance immune function *neovascularization

Question 26

indications of hyperbaric oxygen therapy

Answer 26

Acute- decompression sickness, air/gas embolism, carbon monoxide poisoning, traumatic injury, severe anemia chronic- diabetic wounds, osteomyelitis, actinomycosis, radiation necrosis

Question 27

complications of hyperbaric oxygen therapy

Answer 27

Barotrauma- ear/sinus trauma, tympanic membrane repture, gas embolish oxygen toxicity- CNS toxic reaction, pulmonary toxic reaction other- depression, claustrophobia, decreased cardiac output

Question 28

what is carbogen

Answer 28

carbon dioxide and oxygen

Question 29

what is carbogen used for

Answer 29

hiccoughs, carbon monoxide poisoning, prevent washout of CO2 during cardiopulmonary bypass

Question 30

evidence of documented hypoxemia

Answer 30

PaO2<60mmHg or SaO2<90% breathing room air PaO2 or SaO2 below range for specific clinical situation

Question 31

high flow system differ from low flow

Answer 31

high flow- meeds or exceeds peak inspiratory flow, fixed FiO2, 60L/min low flow-O2 concentration 22-45%,low cost, easy application, disposable

Question 32

simple mask

Answer 32

reservior Liter flow 6-10L FiO2= 35-50% lowest liter flow= 6L CO2 rebreathing