Chapter 38A

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Chapter 38A
2010-09-29 17:48:42

Chapter 38A
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  1. What are the 3 general goals and clinical objectives for oxygen therapy?
    • 1. Correct documented or suspected acute hypoxemia
    • 2. Decrease the symtoms associated with chronic hypoxemia
    • 3. Decrease the work load hypoxemia imposes on the cardiopulmonary system
  2. What are some reasons for assessing the need for O2 therapy?
    • Laboratory documentation: Pao2, Sao2, SpO2
    • Specific clinical problem: carbon monoxide poisoning, postperative cyanide poisoning, acute MI
    • Clinical findings at bedside: tachypnea, tachycardia, confusion, etc
  3. What does oxygen toxicity primarily effect?
    Lungs and central nervous system
  4. What are the determining factors in oxygen toxicity?
    PO2 and exposure time
  5. What can prolonged exposure to oxygen toxicity do?
    Cause infiltrates in lung parechyma
  6. What can occur with an FIO2 above 0.50?
    Absorption atelectasis
  7. PTs breathing small tidal volumes are at the greatest risk of?
    Absorption atelectasis
  8. What are the 3 oxygen delivery systems?
    • 1. Low flow
    • 2. Reservoir
    • 3. High flow
  9. What is low flow?
    PTs inspiratory flow often exceeds that delivered device resulting in air dilution
  10. What is reservoir?
    Provides a fixed FIO2, the reservoir volume must always exceed the PTs Vt and it can not have any leaks in the system
  11. What is high flow?
    Always exceeds the PTs flow providing a fixed FIO2
  12. Does high or low flow mean high/low FIO2 or high/low O2?
  13. What are the 4 low flow systems?
    • 1. Nasal Cannula
    • 2. Nasal Catheter
    • 3. Transtracheal Catheter
    • 4. Reservoir Cannula
  14. What does nasal cannula deliver FIO2 at?
  15. What flow rates - L/min does nasal cannula use?
    1/4 to 6 L/min
  16. Is a humidifier need for a nasal cannula?
    Yes, 4 L/min or greater
  17. What flow - L/min does a nasal catheter use?
    Flows of 1/4 to 8 L/min
  18. How much FIO2 is delivered in a nasal catheter?
  19. Where is the transtracheal catheter placed?
    Surgically placed in the trachea through the neck
  20. What is the flow - L/min for a trantracheal catheter?
    Flow is 1/4 to 4 L/min
  21. What are some things you need to look for when dealing with a transtracheal catheter?
    • Infections because of foreign object and tubing
    • No humidifier because of low flow
  22. What are 2 types of reservoir cannulas?
    • 1. Nasal reservoir
    • 2. Pendent reservoir
  23. What do reservoir cannulas do?
    Stores O2 between PT breaths. PT draws this reserve whenever the inspiratory flow exceeds O2 flow into the device
  24. How much O2 can the reservoir cannula reduce?
  25. What are the 3 different types of reservoir masks?
    • 1. Simple mask
    • 2. Partial rebreathing mask
    • 3. Nonbreathing mask
  26. What is the input flow for simple masks?
    5-10 L/min
  27. How much O2 does partial rebreathing masks deliver?
  28. How many L/mins should the partial rebreathing mask be run at?
    10 L/mins
  29. What should the FIO2 be for nonbreathing masks?
  30. What should L/mins be run at for nonbreathing masks?
    10 L/mins
  31. What is different about nonbreathing masks and partial rebreathing masks?
    Nonbreathing masks has an inspiratory valve on top of bag and expiratory valves cover exhalation ports no mask