Review 5

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  1. PaO2 Target
    60-100 torr
  2. O2 Related Problems
    • O2-induced hypoventilation
    • Reintopathy of Prematurity
    • Denitrogenation Absorption Atelectasis
    • CNS Abnormalities
    • Pulmonary O2 Toxicity/Hyperoxic Acute Lung Injury
  3. Retinopathy of Prematurity Goals
    • Keep PaO2 in 50-60 torr range 1st week of life 
    • 50-70 torr after the first week
  4. Color for O2 cylinder
    Green
  5. Color for air cylinder
    Yellow
  6. Color for Helium Cylinder
    Brown
  7. Color for Helium & Oxygen Cylinder
    brown & green
  8. Color for CO2 Cylinder
    Gray
  9. Color for Nitrous Oxide Cylinder
    Blue
  10. E Cylinder Factor
    0.28
  11. H, K Cylinder Factor
    3.14
  12. Concentrator Concentrations
    • Molecular Sieve: higher flow = lower concentrations. Range <85 to 95%
    • Semipermeable Membranes only deliver 40%
  13. Heliox Factors
    • 80/20 =  multiply observed flow by 1.8
    • 70/30 =                    "                 1.6
    • 60/40 =                    "                 1.4
  14. Cannula Concentrations
    24-44% O2
  15. Simple Mask Concentration
    35-50% O2
  16. Partial Rebreathing Mask Concetration
    40-70% O2
  17. Non-Rebreathing Mask Concentration
    60-80% O2
  18. Minimum flow for Oxygen Hood
    7 lpm
  19. Flow in entrainment masks
    At least 4-6 x the minute volume
  20. Entrainment Device Concentration
    28-100% O2
  21. Indications for Heliox
    • upper airway obstruction
    • tracheal tumor laryngotracheobronchitis (crouo)
    • post extubation stridor
    • small ETT
    • status asthmaticus
  22. Indications for Nitric Oxide
    • Neonates with hypoxic respiratory failure associated with pulmonary hypertension
    • ? ARDS
  23. Indications for Carbogen (CO2)
    hypoplastic left heart syndrome
  24. Usual starting dose for inhaled NO
    20 ppm
  25. Target oxygenation levels for hypoxemic & hypercarbic patients
    • PaO2 maintained between 50-60 torr &
    • saturation between 88-92%
  26. A home care patient has a problem with his O2 concentrator and needs to change to the H cylinder of O2. If the patient's nasal cannula is receiving a flow of 3 lpm and the cylinder pressure is 1300 psig, how long can the patient receive O2?

    A) about 2 hours
    B) about 1300 hours
    C) about 22 hours
    D) about 120 hours
    C) about 22 hours
    (this multiple choice question has been scrambled)
  27. What is the most likely problem to watch for in a patient with severe COPD who is receiving supplemental O2?

    A) pulmonary edema from O2 toxicity
    B) retinopathy of prematurity
    C) hyperventilation
    D) hypoventilation
    D) hypoventilation
    (this multiple choice question has been scrambled)
  28. An order is received to set up a HFNC on a patient. What will be needed?

    A) high pressure O2 & air sources, blender & humidifier
    B) humidifier, high pressure O2 and air, a blender and sterile saline
    C) high pressure air & O2 and a blender
    D) high pressure O2, blender and sterile saline
    A) high pressure O2 & air sources, blender & humidifier
    (this multiple choice question has been scrambled)
  29. A therapist is making general rounds in the hospital and finds a patient whose reservoir tubing has fallen off his T-piece. This would result in which of the following:

    A) increased inspired O2
    B) Increased inspired CO2
    C) decreased inspired O2
    D) decreased inspired CO2
    C) decreased inspired O2
    (this multiple choice question has been scrambled)
  30. The risks of O2 Rx include all of the following except:

    A) retinopathy of prematurity
    B) pulmonary O2 toxicity
    C) denitrogen absorption atelectasis
    D) O2-induced hyperventilation
    D) O2-induced hyperventilation
    (this multiple choice question has been scrambled)
  31. A patient is wearing a face tent because of facial surgery. The nurse moves the patient from an upright to a supine position. What effect will this have on the patient's respiratory status?

    A) increased inspired O2
    B) decreased inspired O2
    C) increased Vt
    D) Increased inspired CO2
    B) decreased inspired O2
    (this multiple choice question has been scrambled)
  32. To minimize the risk of hypoxemia during a treatment or procedure, which of the following should be done?

    A) keep the O2 % the same and make sure the replacement equipment is working properly
    B) increase the O2 % by 20% and minimize the time the pt is breathing RA
    C) minimize the time the pt is breathing RA, increase the O2 to 100% before suctioning & make sure the replacement equipment is working properly
    D) minimize the time the pt is breathing RA and increase the O2% to 100% before suctioning
    C) minimize the time the pt is breathing RA, increase the O2 to 100% before suctioning & make sure the replacement equipment is working properly
    (this multiple choice question has been scrambled)
  33. An anxious 68 YO patient with CHF will not keep the nonrebreathing mask on. What should be recommended to treat the patient's hypoxemia?

    A) 60/40 heliox
    B) HFNC
    C) partial rebreathing mask
    D) 50% air entrainment mask
    B) HFNC
    (this multiple choice question has been scrambled)
  34. A patient is wearing a partial nonrebreathing mask. The reservoir bag almost totally collapses during inspiration. Which of the following should be done?

    A) put a standard nasal cannula on the patient
    B) tell the patient to breathe more rapidly
    C) increase the O2 flow
    D) tell the patient to breathe more slowly
    C) increase the O2 flow
    (this multiple choice question has been scrambled)
  35. When checking a homecare patient's reservoir type nasal cannula, the therapist notices the reservoir does not fill and empty in synchrony with the patient's breathing pattern. Based on this, what should be done?

    A) replace the cannula
    B) decrease the O2 flow
    C) increase the O2 flow
    D) switch the patient to an air entrainment device
    A) replace the cannula
    (this multiple choice question has been scrambled)
  36. What O2 delivery device should be recommended for a patient who has a variable respiratory rate, I:E Ratio and Vt?

    A) transtracheal catheter
    B) simple O2 mask
    C) nasal cannula
    D) air entrainment mask
    D) air entrainment mask
    (this multiple choice question has been scrambled)
  37. The physician asks the therapist which O2 delivery device would be best for a patient who needs about 75% O2. What should be recommended?

    A) nonrebreathing mask
    B) 6 lpm nasal cannula
    C) air entrainment mask
    D) simple O2 mask
    A) nonrebreathing mask
    (this multiple choice question has been scrambled)
  38. A patient has a nasal cannula and needs to be transported on a stretcher. The E-sided cylinder will have to be laid flat under the stretcher. What flowmeter should be recommended?

    A) backpressure-compensated Thorpe
    B) backpressure-compensated kinetic
    C) non-backpressure-compensated Thorpe
    D) Bourdon
    D) Bourdon
    (this multiple choice question has been scrambled)
  39. An E cylinder of O2 needs to be prepared for transport. A regulator with which pinhole locations should be used?

    A) 3 & 5
    B) 2 & 6
    C) 2 & 5
    D) 1 & 5
    C) 2 & 5
    (this multiple choice question has been scrambled)
  40. What is the duration of flow of an E cylinder with 1700 psig that is running at 5 Lpm?

    A) 1.6 hours
    B) 7.7 hours
    C) 13.7 hours
    D) 0.9 hours
    A) 1.6 hours
    (this multiple choice question has been scrambled)
  41. The therapist is called to draw an ABG from a patient who is wearing a 35% air entrainment mask. Upon entering the room, the therapist notices that the patient's covers are drawn up over the entrainment ports of the mask. How would this affect the function of the mask?

    A) the O2% would be decreased
    B) the total flow would be increased
    C) there would be no effect
    D) the O2 % will be increased
    D) the O2 % will be increased
    (this multiple choice question has been scrambled)
  42. A phone call from a homecare patient is received. The patient reports that the high pressure pop-off valve on the bubble humidifier to the transtracheal catheter is venting. In addition, the patient cannot flush out the catheter or push the cleaning rod through it. What should the patient be told to do?

    A) switch to a nasal cannula
    B) force the saline through the catheter until the obstruction is cleared
    C) remove the humidifier and double the O2 flow rate to the catheter
    D) force the cleaning rod through the catheter until the obstruction is cleared
    A) switch to a nasal cannula
    (this multiple choice question has been scrambled)
  43. A 58 YO patient with advanced emphysema is admitted with an acute exacerbation of the condition. While breathing 2 lpm O2 through a transtracheal catheter, the patient has the following ABG's: pH 7.38  pCO2 57  pO2 47 Sat 80%. Based on these findings, what should be done?

    A) change the patient to a nonrebreathing mask with 10 lpm O2
    B) increase the current O2 flow to the system to 3 lpm
    C) initiate bilevel mask ventilation
    D) change the patient to a 24% air entrainment mask
    B) increase the current O2 flow to the system to 3 lpm
    (this multiple choice question has been scrambled)
  44. A comatose patient is intubated and is receiving 35% O2 with an aerosol through a T-Piece. While watching the patient breathe, the therapist notices that during each inspiration, the mist disappears from the downstream end of the T-Piece. What should be recommended?

    A) add aerosol tubing to the end of the T-Piece
    B) tell the patient not to breathe so deeply
    C) change the O2 to 40% and increase the flow
    D) change the O2 to 30% and increase the flow
    A) add aerosol tubing to the end of the T-Piece
    (this multiple choice question has been scrambled)
  45. A 65 YO female patient with pulmonary edema is very SOB and hypoxemic. She is ordered to have a nonrebreathing mask with 10 lpm of O2 going to it. However, she keeps taking off the mask because of her anxiety and claustrophobia. When she removes the mask, her pulse oximeter reading goes from 90% to 82%. What should be recommended to help manage this patient?

    A) sedate the patient so that she will keep her nonrebreathing mask on
    B) begin a HFNC at >10 lpm O2
    C) initiate CPAP by mask at 8 cm H2o and 40% O2
    D) give her a nasal cannula at 10 lpm
    B) begin a HFNC at >10 lpm O2
    (this multiple choice question has been scrambled)
  46. An uncooperative 13 YO patient with status asthmaticus is being treated in the ED. The physician has ordered the patient to receive a 70/30 heliox mixture and continuous aersolized albuterol. What should be recommended as the best way to do this?

    A) HFNC
    B) partial rebreathing mask with reservoir bag
    C) nonrebreathing mask with reservoir bag
    D) through a mechanical ventilator
    C) nonrebreathing mask with reservoir bag
    (this multiple choice question has been scrambled)
  47. A patient with COPD is going home. After a hospital exercise test is conducted, it has been determined that the patient will need 1 lpm O2 only when exercising on a stationary bike or when the patient feels SOB. Which of the following delivery systems should the therapist recommend?

    A) portable LOX system
    B) piston compressor
    C) molecular sieve O2 concentrator
    D) semipermeable membrane O2 concentrator
    C) molecular sieve O2 concentrator
    (this multiple choice question has been scrambled)
  48. The therapist is attempting to calibrate a polarographic O2 analyzer but finds that it cannot be done. Possible reasons for this include:

    A) the battery needs to be replaced & the electrolyte solution has evaporated & water has condensed on the membrane
    B) the gas sampling capillary tube is plugged & the electrolyte solution has evaporated
    C) the membrane is torn on the tube & the electrolyte solution has evaporated
    D) the membrane is torn on the tube, the electrolyte solution has evaporated, the battery needs to be replaced & water has condensed on the membrane
    D) the membrane is torn on the tube, the electrolyte solution has evaporated, the battery needs to be replaced & water has condensed on the membrane
    (this multiple choice question has been scrambled)
  49. A patient has just been admitted to the ED with suspected CO poisoning. The physician wants the patient to receive the highest O2 percentage possible. What should be recommended?

    A) simple mask at 6 lpm
    B) nonrebreathing mask
    C) CPAP mask at 5 cm H2O and 40% O2
    D) 50% air entrainment nebulizer to aerosol mask
    B) nonrebreathing mask
    (this multiple choice question has been scrambled)
  50. A newborn infant with HLHS has just been transferred to the hospital. Mechanical ventilation is being instituted. What else can be done to help improve the neonate's heart function?

    A) NO Rx
    B) heliox Rx
    C) CO2 Rx
    D) close the PDA
    C) CO2 Rx
    (this multiple choice question has been scrambled)
  51. The therapist is doing QA on the department's flowmeters. After a backpressure compensated Thorpe flowmeter is plugged in, the flow is set to 10 lpm. The flowmeter outlet is partially and then completely obstructed. Which of the following should be expected?

    A) the float will stay at the 10 lpm mark
    B) the float will move downward and then to the bottom of the flowmeter
    C) the float will move upward in the flowmeter
    D) the float will move upward and then downward in the flowmeter
    B) the float will move downward and then to the bottom of the flowmeter
    (this multiple choice question has been scrambled)
  52. The therapist is called to evaluate a female patient known to have advanced emphysema. She is wearing a nasal cannula at 6 lpm. The nurse says she has become more drowsy and less responsive since the O2 was given to her an hour ago. Her ABG results on the O2 show:  pH 7.32  pCO2 65 pO2 84. Which of the following should be recommended?

    A) leave her on the cannula &let her rest undisturbed
    B) change her to a simple O2 mask and repeat the gases in 20 minutes & let her rest undisturbed
    C) change her to a 24% air entrainment mask & repeat the gases in 20 minutes & monitor her closely for becoming more alert
    D) change her to a simple O2 mask and monitor her closely for becoming more alert
    C) change her to a 24% air entrainment mask & repeat the gases in 20 minutes & monitor her closely for becoming more alert
    (this multiple choice question has been scrambled)
  53. The therapist is assisting with a bronchoscopy to obtain a biopsy of a suspicious laryngeal node on a patient. Afterward, the patient c/o SOB & a "tight"throat. Which of the following recommendations should be made?

    A) force the cleaning rod through the catheter until the obstruction is cleared
    B) give the patient 80/20 heliox
    C) increase the O2 % by 20% and minimize the time the pt is breathing RA
    D) do a 7 minute helium dilution test
    B) give the patient 80/20 heliox
    (this multiple choice question has been scrambled)
  54. An adult patient who was rescued from a house fire is being received in the ED. The patient is wearing a simple O2 mask at 5 lpm. The SpO2 by pulse oximeter is 100% and his SaO2 from an ABG sample analyzed on a CO oximeter is 73%. What should be recommended at this time?

    A) portable LOX system
    B) maintain the present therapy and recalibrate the CO oximeter
    C) do a 7 minute helium dilution test
    D) change the patient to a nonrebreathing mask
    D) change the patient to a nonrebreathing mask
    (this multiple choice question has been scrambled)
  55. The therapist is working with a patient who has a tracheal tumor. The patient is wearing a nonrebreathing mask with 70/30 heliox. Pulse oximeter sat is 96%. The patient says it is getting harder to breathe and it is noticed that the reservoir bag has collapsed. The most appropriate action is to:

    A) decrease the flow of the gas
    B) switch to a 28% air entrainment mask
    C) switch to 60/40 heliox
    D) increase the flow of the gas
    D) increase the flow of the gas
    (this multiple choice question has been scrambled)
  56. An 8 YO patient with asthma is going to be given 70/30 heliox through a nonrebreathing mask and reservoir bag. The physician ahs ordered the child to receive 7 lpm of the gas. Because it will be delivered through an O2 flowmeter, what flow should be set?

    A) 9.8 lpm
    B) 11.2 lpm
    C) 4.4 lpm
    D) 3.9 lpm
    C) 4.4 lpm
    (this multiple choice question has been scrambled)
  57. A 36 week gestational age neonate is hypoxemic despite mechanical ventilation and has clinical evidence of persistent pulmonary hypertension of the newborn. What can be done to correct the hypoxemia?

    A) begin 10 cm H2o PEEP
    B) begin Carbogen Rx
    C) begin NO therapy
    D) instill intratracheal surfactant
    C) begin NO therapy
    (this multiple choice question has been scrambled)
  58. A therapist is assigned to the ED of a mjor emdical center when a 24 YO patient with status asthmaticus is transferred by ambulance from a small rural hospital. The patient has been given continuous BD therapy and corticosteroids and aminophylline. The patient is becoming exhausted but refuses to allow intubation and mechanical ventilation. What should be recommended?

    A) begin NO rx
    B) follow the patient's wishes
    C) begin heliox rx
    D) intubate & ventilate the patient despite protests
    C) begin heliox rx
    (this multiple choice question has been scrambled)
  59. A neonatal patient has primary pulmonary hypertension and is receiving mechanical ventilation. After the neonate receives 20 ppm of NO therapy, PVR returns to the normal range. What should be recommended at this time?

    A) increase the NO to 30 ppm
    B) D/C the No
    C) decrease the NO to 10 ppm
    D) add 1% carbogen to the NO mix
    C) decrease the NO to 10 ppm
    (this multiple choice question has been scrambled)
  60. A socially active female patient with COPD requires 2 lpm of continuous O2. She wishes to go with her Better Breathers CLub ona bus trip to shop in Chicago. What should be recommended for her in this situation?

    A) take a portable E cylinder of O2 with her and run it at 1 lpm
    B) take a portable E cylinder with her and run it at 2 lpm
    C) preposition E cylinders for her use in various stores
    D) use a portable LOX system at 2 lpm
    D) use a portable LOX system at 2 lpm
    (this multiple choice question has been scrambled)
Author:
n1297f
ID:
316039
Card Set:
Review 5
Updated:
2016-02-18 19:47:14
Tags:
gas delivery
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Description:
Review 5
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