exam 1 - resp support

Question 1

what is the primary indication for oxygen therapy

Answer 1

hypoxia

Question 2

what is hypoxia

Answer 2

inadequate inspired oxygen
impaired pulmonary function
ineffective oxygen transport
increased oxygen demand not met by delivery

Question 3

what values determine need for oxygen therapy

Answer 3

PaO2 < 60 mmHg
SpO2 < 90%

Question 4

clinical signs for needs for oxygen therapy

Answer 4

cyanosis, dyspnea, tachypnea, tachycardia, anxiety

Question 5

when to use flow-by oxygen

Answer 5

until another method can be employed
shock

Question 6

which is better - baggie or face masks

Answer 6

baggie - better tolerated

Question 7

what can an oxygen hood be made from

Answer 7

from an E-collar, or can be bought

Question 8

what form of oxygen therapy uses alot of oxygen and can lose it very quickly

Answer 8

oxygen cage

Question 9

when to use oxygen tent

Answer 9

sedated or depressed patient
short term immediate post op

Question 10

when to use intranasal oxygen

Answer 10

prolonged management

Question 11

when to use intratracheal oxygen

Answer 11

not common but used if contraindications are found for nasal

Question 12

should you use intratracheal oxygen with a tracheal obstruction

Answer 12

no

Question 13

does nasal or tracheal get more bang for buck

Answer 13

tracheal

Question 14

what are guidelines only for O2 administration

Answer 14

FIO2 and PaO2

Question 15

what flow rate do you start at

Answer 15

50-100 ml/kg/min

Question 16

oxygen flow rates should be adjusted based on

Answer 16

SpO2 and PaO2
PaO2 above 100 mmHg

Question 17

which oxygen administrations can reach FIO2 greater than 50-60%

Answer 17

bilateral intranasal and intratrachea via tracheostomy

Question 18

what new oxygen administration can prevent ventilation and control FIO2

Answer 18

high flow oxygen

Question 19

how to monitor oxygen therapy

Answer 19

CS - respiratory rate/character, MM color
pulse ox
arterial blood gas

Question 20

where to put pulse ox on normal vs critical patients

Answer 20

tongue for normal
buccal mucosa for critical

Question 21

how does pulse ox work

Answer 21

red light absorbed by unsaturated Hg
infrared absorbed by oxyhemoglobin

Question 22

how to wean from oxygen therapy

Answer 22

monitor CS, SpO2, serial arterial blood gas, trials off oxygen

Question 23

when to continue oxygen

Answer 23

CS of hypoxia, SpO2 < 96%, PaO2 < 80 mmHg

Question 24

oxygen therapy complications

Answer 24

apnea in patients with severe respiratory disease, intrapulmonary shunting, oxygen toxicity

Question 25

what does oxygen toxicity look like

Answer 25

reasons to put on oxygen edema, atelectasis, consolidation, congestion, hemorrhage, fibrosis, functional impairment

Question 26

pathogenesis of oxygen toxicity

Answer 26

cytotoxic peroxides and free radicals starts after 24 hrs of 100% FIO2 death after 2-3 days 100% FIO2

Question 27

indications for positive pressure ventilation

Answer 27

PaCO2>55 mmHg failure of oxygen therapy to reverse hypoxia adjunctive treatment for intracranial hypertension

Question 28

2 overall techniques of positive pressure ventilation

Answer 28

manual - anesthesia bag, ambu bag mechanical - controlled vs assisted, pressure vs volume related

Question 29

difference between controlled and assisted mechanical ventilation

Answer 29

controlled - machine initiates breath assisted - animal initiates breath

Question 30

what is PEEP

Answer 30

positive end expiratory pressure

Question 31

what is CPAP

Answer 31

continuous positive airway pressure

Question 32

what do you use to treat alveolar collapse

Answer 32

PEEP or CPAP decreases work of breathing

Question 33

usual settings for PEEP or CPAP

Answer 33

5-10 cm H2O

Question 34

specific instances where PEEP or CPAP indicated

Answer 34

100% oxygen doesnt achieve normoxia greater than 50% inspired oxygen is required to maintain normoxia - puts at risk for oxygen toxicity

Question 35

when would you use high frequency ventilation

Answer 35

ventilaiton in presence of tracheal disruption

Question 36

is high frequency ventilatin used often in vet med

Answer 36

no - not available

Question 37

how to wean from ventilation

Answer 37

once stable, gradual reduction in minute ventilation so that spontaneous ventilation can start

Question 38

what to monitor when weaning from ventilation

Answer 38

blood gas, SpO2, ETCO2, respiratory pattern

Question 39

where does air get humidified in the body

Answer 39

nasopharynx and tracheobronchial tree

Question 40

effects of dry medical gases

Answer 40

increased humidification requirement increased vaporization - cooling of liquid surfaces and patient heat loss mucosal drying

Question 41

4 types of humidifiers

Answer 41

bubble heated bubble humidity exchange filters nebulizers

Question 42

aerosol

Answer 42

fine suspension of liquid droplets in carrier gas

Question 43

what is the purpose of aerosol therapy

Answer 43

prevent dessication - water loosen secretions and stimulate coughin - saline treat resp disease - drugs

Question 44

how does size of particles in aerosols affect deposition

Answer 44

smaller particles deposit deeper in the airway

Question 45

how does rate and depth of breathing affect aerosol deposition

Answer 45

slow, deep breath = deep airway rapid, shallow = upper

Question 46

3 types of nebulizers

Answer 46

jet, babbington, ultrasonic

Question 47

how to administer aerosol therapy

Answer 47

mask, enclosure, breathing circuit for 15-20 min q 4-8 hrs can also couple with coupage, bronchodilators

Question 48

what is a convenient way to deliver aerosols to lower airways in hospital setting

Answer 48

thru tracheostomy

Question 49

drugs delivered via nebulization

Answer 49

Abx - aminoglycosides bronchodilators - aminophylline, beta 2 agonists