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Intro to oxygen therapy
Terms in this set (48)
Oxygen is a drug and always requires a _______
what is the primary goal of oxygen therapy?
what can oxygen therapy do for the cardiopulmonary workout and why?
1. decrease the demand on both the heart and lungs
2. oxygen therapy increases the blood oxygen content the heart does not pump as much blood per minute to meet oxygen demands
correct document or suspected actue hypoxemia
increase alveolar and blood levels of O2
decrease the symptoms associated with chronic hypoxemia
relieves symptoms of certain Lunt disorders dyspnea and my increase mental function
decrease workload hypoxemia imposes of the cardiopulmonary system
increases ventilation and cardiac output
how do we identify a patient who is need of supplemental oxygen?
2. Specific clinical condition/problem
3. pulse oximetry and or arterial blood gas measurement (sp02, sa02, Pa02)
What is the most definitive method of assessing arterial oxygenation?
arterial blood gas
what are the signs of hypoxemia?
What happens when a patient is hypoxic?
1. eventual arrythmia
4. impaired vision
5. impaired mentation or coma
what are some patients that can benefit from supplemental oxygen therapy?
patient experiencing C0 poisoning
cardiac emergencies (including myocardial infarction)
1. saturation of oxygen- pulse
2. saturation of oxygen -arterial
3. Partial pressure of oxygen- alveolar
4. Partial pressure of oxygen -alveolar
value gained from pulse oximetry reading?
value for data gained from ABG 02 saturation?
VALUE FOR DATA GAINED FROM ABG
MEASURED partial pressure oxygen
Value data gained from the alveolar air equation?
1. Pa02 less than 60 mmHg in patient breathing room air
2. Sa02 less than 87 to 90% in patient breathing room air
3. Pa02 or Sa02 below desired range for a specific clinical situation
4. Acute care situations in which hypoxemia is suspected
5. acute myocardial infarction
6. short term therapy
7. cardiopulmonary resuscitation
AARC clinical practice guidline
What are the contraindications to supplemental oxygen therapy?
no specific contraindications to supplemental oxygen therapy exist in adult patients in the presence of suspected or confirmed hypoxemia or in the reasonable prevention of hypoxemia
what are the hazards of supplemental oxygen?
1. hyperemic acute lung injury
2. depression of ventilation
3. reinopathy of prematurity
4. absorption atelectasis
5. fire hazard
Hyperoxia is defined as a Pa02 GREATER than ___________?
What does a Pa02 greater than 300 mmHg cause?
decreased perfusion to brain/heart/skeletal muscles
the extent of harmful effects determined by Pa02 and time exposure
What is the physiologic response to hyperoxia in healthy individuals in the first 0-12 hours?
Normal function to sub-sternal chest pain
What is the physiologic response to hyperoxia in healthy individuals in 12-24 hours
decrease vital capacity
What is the physiologic response to hyperoxia in healthy individuals in the first 25-30 hours
Decreasing lung compliance
increasing A-a gradient
Decreasing Exercise P02
What is the physiologic response to hyperoxia in healthy individuals in 30-72 hours
Decreasing diffusion capacity
What is the primary physiologic response to hyperoxia in healthy individuals Primarily affects the lungs and central nervous system?
What are the physiologic responses to hyperoxia in healthy individuals?
1. presents similarly to bronchopneumonia (patchy infiltrates in lower lung feilds
2. alveolar inury
3. capillary endothelium damage
4. interstitial edema
5. thickening of the A-C membrane
What causes oxygen toxicity and why?
Overproduction of oxygen free radicals because they can damage and kill cells
What is the goal of oxygen therapy? and when ending therapy what should we always do?
1. Use the lowest FI02 compatible with adequate tissue oxygenation
2. wean a patient off oxygen therapy
When a FI02 is less than .40 when should you monitor your patients oxygen ?
within 12 hours
When a FI02 is less than .40 or greater when should you monitor your patients oxygen ?
within 8 hours
When a patient has a acute MI
within 72 hours
When a patient has diagnosis of COPD?
within 2 hours
When a patient is a neonate?
within 1 hour
all oxygen systems should be checked at least ______ times a day
1 time per day
Pa02 greater than _______________ may depress ventilation in some patients with Chronic hypercapnia
Fi02 greater than ________ may cause atelectasis, oxygen toxicity, and or cilia or leukocyte depression?
In premature infants oxygen Pa02 greater then ______ may contribute to retinopathy of prematurity.
What is the goal of oxygen therapy?
use the lowest possible Fi02 to achieve adequate tissue oxygenation.
Outcome is determined by clinical and physiologic assessment to establish adequacy of patient response to therapy? how do we monitor the assessment?
1. ABG- we look for increases in Pa02
2. Pulseoximeter- we look for increases of Sp02
What is the primary reason COPD patients hyperventilate when given oxygen is most likely the suppression of the _______
The increase in blood oxygen levels in these patients suppress ___________ _________, ____________ _________ and elevates the __________
1. peripheral chemorecptors
2. ventilatory drive
3. elevates the Pac02
Preventing hypoxia is always the first priority even in patients with COPD we should never with hold oxygen to a patient but we need to carefully monitor ______, ________, and ________ is REQUIRED?
1. pulse oximetery
3. patient observation
What causes retinal vasoconstriction in premature or low birth weight infants?
What is the American academy of pediatrics reccomendation keeping the P02 in an infant less than _______ to minimize risk of ROP?
A Fi02 greater than _______ presents significant risk for absorption atelectasis?
How does high Fi02 cause absorption atelectasis?
1. high Fi02 oxygen diffuses rapidly across the AC membrane
2. poorly ventilated alveoli do not allow repletion of oxygen once defused (obstruction low tidal volume, CNS dysfunction)
3. The rate of diffusion is faster than the flow of gas in the alveoli
4. alveoli become unstable and susceptible to collapse
how can Oxygen be a fire hazard to our patient?
1. oxygen supports combustion
2. prolong supplemental oxygen use can increase ambient Fi02
3. patients wearing supplemental oxygen delivery devices have a steady supply on or near face
4. Heat and or point of combustion can cause firse that oxygen supply will support
Patient smoking wearing a delivery device at exceptional risk for fire and burns
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