Respiratory Procedures | Unit 2 Exam review

Medical Gas Therapy

List the Clinical Objectives of Oxygen therapy

Correct documented or suspected acute hypoxemia

Decrease the workload hypoxemia imposes on the cardiopulmonary system(work of heart)

Decrease symptoms associated with chronic hypoxemia(WOB)

Hypoxemia

abnormal deficiency of O2 in the arterial blood

Hypoxia

abnormal condition in which the O2 available to the body cells at tissue level is inadequate to meet metabolic needs

what are the levels of hypoxemia

normal

mild

moderate

severe

what is the normal range for hypoxemia

80-100 mmHg

what is the mild range for hypoxemia

60-79 mmHg

what is the moderate range for hypoxemia

40-59 mmHg

what is the severe range for hypoxemia

below 40 mmHg

what are the different types of Hypoxia

hypoxemic

circulatory

anemic

histoxic

Hypoxemic hypoxia

PO2 of the arterial blood is low

when does Hypoxemic hypoxia occur

occurs when in higher altitudes, and with liung diseases with diffusion impairments (emphysema, pneumonia)

circulatory hypoxia

blood flow to the tissues is low

when does circulatory hypoxia occur

occurs when the heart isnt pumping correctly (CHF), and with sickle cell anemia (malformed cells cause clot)

anemic hypoxia

amount of hemoglobin to carry O2 is low

when does anemic hypoxia occur

occurs with carbon monoxide poisoning, sickle cell anemia (not enough healthy cells)

histoxic hypoxia

tissues are poisoned and cannot utilize O2

when does histoxic hypoxia occur

occurs with cyanide poisoning, it will inhibit cellular metabolism; cells cannot process O2

refractory hypoxemia

Severe hypoxemia that is unresponsive to increased levels of O2

What are the primary organ system (s) affected by O2 toxicity

Central nervous system

pulmonary

renal

ocular damage

What are the potential hazards of Oxygen Therapy

Oxygen induced hypoventilation

absorption atelectasis

retinopathy or prematurity in infants

oxygen toxicity

What is the Rule of 4

When the liters per minute increase, the percentage of FiO2 will also increase but by 4%.

when does the rule of 4 apply

only when the patient is breathing at a normal rate and depth

what is an example of the rule of 4’s

1Lpm = 24%FiO2

2Lpm = 28%FiO2

3Lpm = 32%FiO2

4Lpm = 36%FiO2

5Lpm = 40%FiO2

6Lpm = 44%FiO2

What items are necessary for an Oxygen Order

FiO2

duration

delivery device

When the reservoir bag of a partial rebreather or non-rebreather deflate, what is the appropriate action

Flow needs to be increased

What are the indications for Hyperbaric Oxygen Therapy (HBO)

Decompression sickness

Air of gas embolism

Carbon monoxide or cyanide poisoning

Acute traumatic ischemia

What are the possible hazards/complications of HBO?

high pressures

oxygen toxicity

fire or worsening of certain existing conditions

High pressures

Pulmonary oxygen toxicity

Fire and sudden decompression

Describe the benefits of HBO for carbon monoxide poisoning

Lessens the time it takes to treat carbon monoxide poisoning

What is HBO’s effect on Carboxyhemoglobin

If they breathe room air it would take 5 hours to remove carbon monoxide

How does HBO treatment differ from 100% oxygen administration for the treatment of Carboxyhemoglobin

When you put them on 100% O2, it would take them 80 min while with HBO at 3 ATA it would take 23 min

Define the primary indication for Heliox Therapy

Can decrease wob for patients with airway obstruction

What are the conversion factors for an 80:20 for a Helium-O2 mixture

1.8

What are the conversion factors for an 70:30 for a Helium-O2 mixture

1.6

How do you calculate a Helium-O2 mixture

by multiplying the indicated flow by the factor, for every 10 l/min indicatd flow 10x1.8= 1 l/min delivered

What do you need to do to ensure proper mixture of concentration before administering Heliox to a patient

know the conversion factors and make sure you have the appropiate flow

What are the common mixtures of Carbon Dioxide and Oxygen

5% CO2, 95% O2 or 7% CO2, 93% O2

What are the common mixtures of Carbon Dioxide and Oxygen used for

hiccups and carbon moxide poisoning

Air: oxygen Ratio purpose

to find the total flow given to patient

Total flow of Air Entrainment Devices purpose

the amount of oxygen and air being delivered to a patient using and air-entranment mask

Alveolar Air Equation purpose

used to approximate the partial pressure of oxygen in the alveolus

Alveolar/arterial Oxygen Gradient purpose

the differnece in O2 concentration between the alveoli and the arterial blood.

Oxygen Content purpose

the amount of oxygen bound to hb plus the amount of oxygen dissolved in the plasma

Alveolar Air Equation

PAO2= [(pb-PH2O)xFiO2]-(PaCO2 x 1.25)

Alveolar/arterial Oxygen Gradient equation

A-aO2= PAO2-PaO2

Oxygen Content equation

CaO2= (hb x 1.34 x SaO2)+(PaO2 x .003)

Air: oxygen Ratio equation

100- FiO2 / FiO2- O2= value for air/ value for oxygen

Total flow of Air Entrainment Devices equation

multiply the total parts of the air: oxygen ratio by the flow