Chapter 42 Egan's Flashcards

1
Q

What can always provide an exact FiO2?

A

Nonrebreathing reservoir

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2
Q

What system allows precise control over FiO2 and total output flow?

A

Blending system

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3
Q

Protocol-based O2 therapy ensures…

A

1) Undergoes initial assessment
2) Evaluated for protocol criteria
3) Receives a treatment plan that is modified to needs
4) Stops receiving therapy as soon as is no longer needed

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4
Q

O2 therapy is used for

A

correcting hypoxia, decreasing symptoms of chronic hypoxemia, decreasing cardiopulmonary workload

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5
Q

When is high FiO2 acceptable?

A

If concentration can be decreased to .70 within 2 days and .50 in 5 days

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6
Q

Fire triangle

A

O2, heat, fuel

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7
Q

What does the iNO machine do?

A

Improves blood flow to ventilated alveoli, reduces intrapulmonary shunting, improves arterial oxygenation, decreases pulmonary vascular resistance and pulmonary arterial pressure

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8
Q

What does back pressure decrease?

A

The volume of entrained air and the total output of air-entertainment devices

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9
Q

3 Ps

A

purpose, patient, performance of device

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10
Q

Air-entrainment nebulizers are also known as what?

A

jet nebulizers or large volume nebulizer

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11
Q

Venturi mask

A

AEM

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12
Q

Simple mask

A

5-10L/min

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13
Q

What is the body humidity

A

37 degrees Celsius, 47mm Hg partial pressure, 100% saturation

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14
Q

What is the purpose of a baffle in a large volume nebulizer?

A

Stabilize particle size

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15
Q

What controls the particle size generated by an ultrasonic nebulizer?

A

Frequency

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16
Q

What happens to FiO2 when back pressure is applied distally?

17
Q

Low Flow

A

Nasal cannula (variable)
1/4-6L/min 22%-40% FiO2
Nasal catheter (variable)
1/4-5L/min 22%-45% FiO2
Transtracheal catheter (Variable)
1/4-4L/min 22%-35% FiO2

18
Q

Reservoir Systems

A

Reservoir cannula (Variable)
1/4-4L/min 22%-35% FiO2
Simple Mask ( Variable)
5-10L/min 35%-50% FiO2
Partial Rebreathing (variable)
min 10L/min 40%-70% FiO2
Nonrebreather Mask (Variable)
Min 10L/min 60%-80% FiO2

19
Q

High Flow

A

AEM (Fixed)
>60L/min 24%-50% FiO2
Air-Entrainment Nebulizer
(Fixed) 28%-100% FiO2
10-15L-input >60L output
Blending System (Fixed)
>60L/min 21%-100%
High-Flow Nasal Cannula
(Generally Fixed, depends)
Up to 50L/min or more
35%-100% FiO2

20
Q

Enclosure

A

Oxyhood =/>7L
21%-28% FiO2 (Fixed)
Isolette (Variable)
8-15L/min 40%-50% FiO2
Tent (Variable)
12-15L/min 40%-50% FiO2

21
Q

What are the numbers for hypoxemia?

A

PaO2 <55-60mm Hg
SaO2 <87%-90%

22
Q

What typically occurs first when monitoring the earliest physiologic response to breathing 100% O2?

A

Substernal chest pain

23
Q

A patient breathing 100% O2 for 24hrs or longer would most likely exhibit what?

A

Decreased vital compacity

24
Q

What is consistent with the radiographic appearance after prolonged exposure to O2?

A

Patchy infiltrates

25
Signs of hypoxia
Respiratory, Cardiovascular, Neurologic
26
Respiratory signs of hypoxia
Tachypnea, dyspnea, paleness, cyanosis
27
Cardiovascular signs of hypoxia
Tachycardia, arrhythmia, hypertension
28
Exposure time to 100% O2 complications
0-12 hours -normal pulmonary function -tracheobronchitis -substernal chest pain 12-24 hours -decreasing vital compacity 25-30 hours -decreasing lung compliance -increasing P(A-a)O2 and (A-a)gradient -decreasing exercise PO2 30-72 hours -decreasing diffusing compacity
29
When is high FiO2 acceptable?
If concentration can be decreased to 70% within 2 days and 50% within 5 days
30
Air Embolism Treatment
Immediate pressurization in air to 6ATA for 15-30min, then decompression to 2.8ATA with prolonged O2 therapy
31
Carbon Monoxide Treatment
Breathing 100% O2 reduces to 80 minutes HBO at 3 ATA is 23 minutes
32
Helium Canisters
20:80 = 1.8 30:70 = 1.6
33
What is the density of air?
1.293g/L