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96 Cards in this Set
- Front
- Back
hypoxia |
low oxygen |
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hypoxemia |
low oxygen in the blood |
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fio2 |
fraction of inspired oxygen |
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flow |
air current bringing oxygen with it |
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What are the goals of oxygen therapy? |
decrease WOB, resolve or decrease hypoxemia, decrease cardiac work |
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When do you know when to use oxygen therapy? |
lab or bedside measurement, the nature of the med. problem, symptoms that point to hypoxia |
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what is pao2? |
partial pressure of oxygen in arterial blood |
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what is sao2? |
saturation of hemoglobin in artery of oxygen. percentage, blood test |
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what is spo2? |
saturation of oxygen based on the pulse. oximeter, no blood drawn |
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COPD patinets |
keep on low oxygen because they are not used to having that much o2 due to the amount of co2 in their body. |
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What is in the fire triangle for oxygen? |
fuel, ignition, oxidizer. if o2 is >23.5%, it is oxygen enriched. |
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How much oxygen would you use for an emergency? |
100% |
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How should o2 as a drug be treated? |
always use the lowest therapuetic dose. go up and down in 10% increments. |
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What are the 3 basic types o2 deliver systems? |
low flow, high flow, reservoir |
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Describe low flow therapy |
you provide only PART of the patients total breath. rest of it is supplied by air around device. |
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Nasal cannula |
low flow device |
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nasal cannula lpm? |
1-6 lpm
|
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nasal cannula fio2? |
.24-.44, go up by 4's to get approx. fio2 |
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can you use humidity with a nasal cannula? |
yes, at 4 lpm or greater |
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nasal catheter |
rarely used in health care |
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nasal catheter lpm? |
1/4-8 lpm |
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nasal catheter fio2? |
.22-.45 |
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TransTracheal catheter |
placed between 2nd and 3rd trach rings, reduces o2 use up to 50% |
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transtrach catheter lpm? |
1/4-4 lpm |
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50cc reservoir cannula |
conserves o2, comes in cannula or pendant
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Simple o2 mask |
low flow device, has exhalation ports (little holes on the side) |
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simpe o2 mask lpm? |
6-10 lpm. needs at LEAST flow of 6 to flush out co2 |
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simple o2 mask fio2? |
.4-.55 |
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can you use a simple o2 mask with a humidifier? |
yes you can for long term therapy only. |
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Partial rebreather mask |
low flow device. NO VALVES, allows for air entrainment. has bag attached |
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partial rebreather mask lpm? |
6-10 lpm or higher to keep bag inflated |
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partial rebreather mask fio2? |
.6-.65 |
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non rebreather mask NRB |
low flow device, has VALVES to prevent co2 rebreathing. at least 3 valves. has bag attached. can remove valves to make it a partial rb |
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non rebreather mask lpm? |
10+ to keep bag full. must keep bag full to meet patients demand |
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non rebreather mask fio2? |
.21-.8 |
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What happens if a non rebreather mask doesn't deflate somewhat during inspiration? |
valve may be jammed, seal may need to be tightened, flow may be too high |
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High flow oxygen devices |
deliver the patients ENTIRE breath. at least 40 lpm total flow. |
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Venturi mask (venti) |
high flow device. |
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can you use a humidifier w/ a venti mask? |
no you can not due to dynamics |
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venti mask lpm? |
40+ lpm |
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venti mask fio2? |
.25-.55 |
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What kind of tubing goes with a venti mask? |
6 inch corrugated tubing. it widens after a restriction. it helps keep %'s constant even when total flow varies |
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what is the equation to find the total flow for a venti mask? |
sum of air to o2 ratio x set flow rate = total flow |
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What are some high flow devices? |
aerosol mask, trach mask, face tents, briggs T adapters |
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Pediatric tents |
high flow device |
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ped tents lpm? |
>12 lpm to flush co2 |
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can ped tents be humidified? |
yes |
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ped tents fio2? |
.4-.5 |
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What are some cons of ped tents? |
can lead to fluid overload, fio2 is inconsistent and need to tuck sides in better
|
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oxygen hood |
high flow |
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oxygen hood lpm? |
7-15 lpm to flush out co2 and give constant fio2 |
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oxygen hood fio2? |
n/a |
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oxygen hood cons? |
overheating, can cause dehydration and apnea, underhating increased demand for o2, loud |
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What does a venti mask always have to have with it? |
a collar |
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aerosol mask |
high flow, 2 big holes on the side, large bore tubing, hooks up to LVN, only need 1 flowmeter |
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aerosol mask lpm? |
12-15 lpm
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aerosol mask fio2? |
.21-1 |
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who can use an aerosol mask? |
anyone |
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large volume nebulizer |
can use with artificial airway, gives increased humidity, heat control |
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LVN fio2? |
fixed if <35% |
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LVN lpm? |
max input flow 12-15 lpm |
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How can you boost fio2? |
increase the flow, add expiratory tubing (horns/tee), add a reservoir bag, wye adapt 2 systems, set to lower fio2 to increase total flow and bleed in o2, use a high flow nebulizer, use a blender |
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what do you connect to a trach for o2 delivery? |
trach ring, trach tee, briggs tee, trach collar or mask |
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what happens if the tubing kinks on a LVN? |
increase the fio2 |
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what happens if the entrainment port becomes occluded? |
causes the fio2 to increase and the total flow to decreased
|
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define entrainment |
gas and air coming together. |
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magic box equationto find TOTAL FLOW |
100-%O2/%O2-21 ... add the results ... multiply by the set o2 flow |
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high flow nasal cannula |
non-heated. expensive, |
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high flow nasal cannula lpm? |
9-15 lpm |
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high flow nasal cannula fio2? |
.45-.75 |
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high flow nasal therapy |
opti-flow, vapotherm |
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high flow nasal therapy fio2? |
.21-1 via blender |
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what is special about high flow nasal therapy? |
uses heated wire tubing, heated humidity res w/ sterile water, expiratory filter |
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high flow nasal therapy lpm? |
1-60 lpm |
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opti-flow lpm? |
1-60 lpm |
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opti-flow fio2? |
.21-1 |
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vapotherm |
7 cannula sizes |
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opti-flow |
3 cannula sizes |
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vapotherm lpm |
<40 lpm |
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vapotherm fio2 |
.21-1 |
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what are the benefits of using high flow nasal therapy? |
delivers high fio2 accurately, provides patient comfort, improves oxygenation, mucociliary clearance, easy to give and maintain |
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what does the high flow nasal therapy do? |
warm humidified air, improves lung compliance, washes out nasopharyngeal space, reduced metabolic cost, opens alveoli, meets patients peak inspiratory flow, decreased WOB |
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how do you use a high flow nasal therapy |
set temp at 39*C, muffler is available |
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oxymask lpm |
1-40 lpm |
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oxygen analyzers |
measure fio2, require calibration |
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when do you use an o2 analyzer? |
EVERY TIME the fio2 is changed. (10% rule of thumb) |
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what are the types of o2 analyzers |
polargraphic and galvanic fuel cell |
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polagraphic analyzer |
runs on battery ad electrolyte solution |
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what do you do if the polargraphic analyzer doesn't work |
change battery or change electrolytes |
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clark electrode |
used to measure blood o2 |
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what is inside the polargraphic? |
silver anode, platinum cathode |
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how does the silver anode work? |
reaction with chloride relases electrons causing a current |
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Galvanic fuel cell analyzer |
no actual battery, the fuel cell is the battery |
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how does the galvanic fuel cell work? |
chemical reaction between gold and hydroxide solution |
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what would affect the readintg of a galvanic fuel cell? |
high ambient pressure, change in altitude, water on electrode, high airway pressures |
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what is inside the galvanic fuel cell? |
lead anode and gold cathode. NO BATTERY. cell is battery. |