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Terms in this set (51)
What are controlled environments?
Enclosed or semi enclosed
ambient area inside regulated for temperature humidity and Fi02
limited in scope and use
1. servo controlled enclosure, blending system
2. supply supplemental oxygen and humidity
3. temperature controlled
4. assit in sound and isolation
What can be used sometimes inside a incubator so we can offer more control of supplemental oxygen?
In a incubator what will vary do too opening the unit for patient care?
what is a semi enclosed, temperature controlled, has a adjustible height and light sources for staff and is capable for mobility?
1. best method for administering controlled oxygen therapy for infants
how is oxygen delivered in a oxy hood?
heated air entrainment nebulizer
blending system with a heated humidifier
What is the flow rate for a Oxy hood?
What type device supply oxygen and moisture, and is cooled and ventilated to prevent c02 accumulation and heat accumulation?
Oxygen/Mist /Croup tent
What are disadvangtes of tents?
1. Maximum of 40-50% with a liter flow
2. 12 to 15 l/min
3. infection controll is a challenge
What is the general purpose of all oxygen therapy?
to treat and or prevent hypoxemia
What should we consider when a patient is hypoxic?
1. severity of the problem
2. Pa02/Sa02 reading
3. nature of the injury/ disease
oximeter is the measurement of blood hemoglobin saturations using?
a process of light absorption or the absorption of different wavelengths of its is called?
What are the two types of light to detect the amount of oxygen absorption or Hb molecule?
1. red light
2. infrared light
what is a laboratory analytical procedure requiring invasive sampling of arterial blood? and this is invasive?
What is the special equipment that can analyze co-oxemetry?
arterial blood gas analyzer
What estimates arterial blood oxyhemoglobin saturation levels and is abbreviated Sp02, and is used to refer pulse oximetry readings?
what are the AARC clinical practice guidelines that are indications for a pulse oximetry?
1. monitor adequacy of arterial oxyhemoglobin saturation
2. to quantify the response of arterial oxyhemoglobin saturation to therapeutic intervention or to diagnostic procedures
3. comply with mandated regulations or recommendations by authoritative groups
What are contraindications of pulse ox?
1. ongoing need for actual measurements of PH,
2. Pac02 total hemoglobin, and abnormal hemoglobins
What is the assessment need of a pulse ox?
1. Sp02 measurement is a quick and non-invasive way to determine estimations of Pa02 levels
2. continous and prolonged monitoring during sleep
4. qualify individuals who potentially need long term continuous supplement oxygen
4. SP02 may be adequate when assessment of cid base status or Pa02 is NOT required
Pulse oximeters are accurate within ________________
+/- 3 to 5 %
The lower the actually Sa02 the less accurate and reliable is the
What percentage are SP02 considered unreliable?
The pulse oximeter should only confirm what you suspect in terms of ___________________
How can we be accurate in our Pulse oximetry?
Pa02 via ABG should be drawn
1. Always follow manufactures recommended protocol
2. never mix sensors amoung different devices
3. make sure the sensor is properly applied (not to tight/loose)
4. before recording reading make sure its accurate of the pulse signal
5. make sure too allow appropriate response time
6. continuous reading set a alarm 88-92%
7. validate the initial SP02 reading against Sa02 reading
8. disinfect in between patients
9. change continuous monitoring and change when needed
10 never act upon Sp02 reading alone Check the patient
11. avoid using pulse oximetry to monitor hyeroxia in neonates
Key points performing Pulse ox
1. date and time of the measurement reading
2. FI02 or 02 delivery device
3. probe placement
4. result of both Pa02 and Sp02 is taken simultaneously
5. stability of reading (Signal strength)
6. Patients clinical appearance
What should we document with Sp02
What are factors that the pulse ox is inaccurate?
1. caution obtaining readings when you have a marginal or weak signal
2. HR on device does not match palpated pulse ox
3. pulse ox is slow to respond
4. Nail polish, artificial nails, or nail art
While using a pulse ox and a patients signal is week what do you do?
check patients capillary refill, poor profusion will give inaccurate results
If a patient has cold figures and a poor capillary refill while using a pulse oximetry what do you do?
Change monitoring site
use approved ear probe
When the patient has a systematic or body wide percussion issue what should we do? (After trouble shooting has failed?
Recommend a ABG
a device to process and verify Fi02 delivered flow
What are the two types of oxygen analyzers? what type of category are they?
What type of analyzer uses a oxygen mediated chemical reaction to generate electrical current?
Galvanic oxygen analyzer
What type of analyzer use gold cathode and lead anode that is immersed in potassium hydroxide bath for activation?
Galvanic oxygen Analyzer
What type of analyzer do not have to be turned on. They continuually read 21% oxygen when the sensor exposed to room air?
What must we do to prolong the life of the sensor or probe?
keep the sensor capped
What is another name for polarographic oxygen analyzerS?
Analyzers use a oxygen mediated chemical reaction to create current flow?
what analyzer contain a platinum cathode and a silver anode immersed in a potassium hydroxide bath to activate it?
Clark electrodes or polarographic oxygen analyzers
What analyzer requires a 9 volt battery to polarize the silver anode also has a faster read out time?
What analyzer operates on the principle of "thermal conductivity" and the use of a "Wheatstone bride"
Electrical oxygen analyzers
What analyzer has two parallel wire to receive current low from an external power source (battery), using a wire exposed to room air as a reference ?
Electrical oxygen analyzers
IF the sample gas contains a higher oxygen to nitrogen ratio than room air the sample wire cools and its resistance __________` because oxygen is a better conductor than of heat than nitrogen
What is the primary advantage of electrical analyzers vs. chemical analyzers
partial pressure have no affect of reading
What is the disadvantage of Wheat-stone bridge analyzer?
its ability to generate heat can not be used in the presence of flammable gasses
When should FI02 be measured?
only when a device is properly calibrated
What is considered the 2 point calibration?
1. sensor first is exposed to 100% oxygen
2. expose sensor to room air (21%)
3. confirm the reading of 21%
After we calibrate the our analyzer what would be considered a accurate calibration
What are the 3 common causes of analyzer malfunction? What is the VERY first thing we check
1. Low batteries --- > always check the batteries first
2. sensor depletion
3. Electronic failure
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