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Oxygen therapy


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Normal functioning of the lungs depends on what three factors?
patent respiratory tree, functioning alveoli system, well functioning cardiovascular system
What is meant by a patent respiratory tree?
open, able to move air. If there is an occlusion or obstruction it is not patent and will have a negative impact on the respiratory sys.
What is the main function of the upper airway?
warms air, humidifies, filters air, and helps get microorganisms out
What are cilia and what are their main function?
hair like projections in the airway that help get contaminants out of the respiratory tree.
What are the functions of mucus and coughing?
Mucus helps to capture microbs while coughing helps move secretions out.
What helps to thin mucus in the lungs?
What is the function of surfactant?
helps to keep the alveoli open/inflated and decreases surface tension
What is ventilation?
the movement of air in and out of the lungs
define/describe inhalation
active process, muscles contract, diaphragm moves down, pressure goes down and air rushes in
define/describe exhalation
passive process, muscles relax, diaphragm moves up, pressure goes up and air rushes out
What are 3 factors that affect respiration?
Accessory muscles, lung compiance, and airway resistance
What are the accessory muscles and what do they do?
They are the abdominal, intercostal, and sternocleidomastoid muscles which help the distressed pt. move air
What is lung compliance?
elasticity of lungs to expand; how easily the lungs expand. Decreased lung compliance means decreased elasticity
What factors affect lung compliance?
chest wall factors (position of the body-MS, obesity, lying in bed, etc.) and lung factors (problems in the lungs- pneumonia, fibrosis, pulmnary edema, etc.)
What is atelectasis?
decreased expansion of the lungs
What is pleural effusion?
collection of fluid between lung and chest wall. Fluid collapses the lungs.
What is pulmonary edema?
fluid inside the respiratory tree such as with lf. side heart failure- blood gets backed up into the lungs and dumped into the alveoli because heart can't pump it out properly.
What is pulmonary fibrosis or pulmonary htn?
after an injury occurs fibrin and collagen are laid down to repair which toughens lung tissue and decreasing compliance
What is pneumothorax?
a collapse of a portion of lung with air in the pleural space
What is hemothorax?
blood in the pleural space
What can cause airway resistance?
any obstructions to airflow: narrowed tube, tumor, infection, secretions, edema, foreign objects, bronchial constriciton, etc.
define diffusion
movement of SOLUTES from an area of greater concentration to an area of lesser concentration
define osmosis
movement of SOLVENT from and area of lesser concentration to an area of greater concentration
define perfusion
movement of fluid (blood) through or into a system (blood entering vessels through walls)
Diffusion and perfusion are interrelated, therefore can you have one without the other?
Yes, it is possible to have diffusion but not perfusion however diffusion will not be effective. For example air is moving into the lungs, but there is a blocked area of tissue so perfusion is not happening
What things effect diffusion in the lungs?
surface area (less area = less diffusion), disease, and a decrease in environmental O2
What types of things can affect the amount of surface area in the lungs?
body position, tumor, lung collapse, lung removal, muscus plug, immobility, etc.
How is oxygen transported through the body?
97% is attached and transported via hemoglobin and 3% is dissolved into plasma
The amount of oxygen that binds to hgb depends on what?
PaO2 : more PaO2 the more oxygen that attached to Hgb
What is a normal PaO2?
between 80-100mmhg
At a PaO2 of 60mmhg how saturated are the Hbg with oxygen (SaO2)?
What is hypoxemia?
decreased O2 in blood and causes hypoxia
What is hypoxia?
decreased O2 in the tissues
What are some sx/s of hypoxia?
cyanosis, pale coloration of skin, apprehensive, restless, confused, c/o dyspnea
What controls respirations in a healthy person?
CO2: CO2 crosses the bbb and mixes with H2O. H+ ions increase which causes faster breathing.
What controls respriation in a nonhealthy person?
O2 : since a nonhealthy person lives with high levels of CO2 because of the build up, O2 must therefor control the respiratory drive. Low levels of O2 increases breathing
Why is it important to monitor a pt. with COPD who is on oxygen?
Because if the O2 levels get too high then their respriatory drive is not triggered and the pt. can stop breathing
What are two ways of measuring O2 in the blood?
ABG (arterial blood gas) and Pulse oximeter (saturation of O2)
What are the normal ranges of PaO2 and PaCO2?
What does and ABG tell us?
How well diffusion is functioning in the lungs
What would a venus draw(VBG) tell us?
how much O2 is being used by the tissues; tells us the O2 demand in the peripheries
True or false?ABG will help us make critical decisions and tells us if the pt. needs O2 therapy.
What is a normal level on a pulse ox?
95-100% but anything over 90% is good
True or false? pulse ox will help us make critical decisions and tells us if the pt. needs O2 therapy.
False. It does not help make critical decisions, but may determine if a ABG is needed
How can a pulse ox give a misreading of O2 saturation?
If Hgb is low but still 90% saturated it could read 90%SaO2 when the pt. is actually hypoxic or hypoxemic because of the low Hbg levels
What types of pts need O2 therapy?
if they are hypoxic or hypoxemic, someone with a non-respiratory problem and demands more O2 to the tissues such as a febrile pt, someone with low levels of Hgb such as with blood loss or burn victims, someone with reduced O2 carrying ability such as a post-op pt, someone with decreased cardiac output
What is the % of O2 (fraction of inspired air FiO2) in room air?
True or false? If over 2L/min of O2 is delivered then it needs to be humidified.
True or false? you need a dr. order to humidify but not to administer O2.
False. Oxygen is considered a drug and you need a dr.s order for it however you do not need an order to humidify
Up to how many L of O2 can be given with nasal prongs?
simple face mask
delivers 5-8L/min O2, 40-60% FiO2, fits snugly, has vents to pull in room air and expel CO2
Partial rebreather
has reservoir bag and vents, needs humidity, delivers 5-11 L/min O2, 60-75% FiO2,
same as partial rebreather except it has vents, prevents outside air and exhaled CO2 from mixing with O2, needs to be monitored, delivers 6-15 L/min O2, 80-90% FiO2
Venti mask
only delivers up to 50% FiO2 but is more accurate than other masks because you can control the amount of O2 and room air that is given
What are 5 precautions when using oxygen?
1. no open flames 2. make sure electrical equ. is working properly 3. don't use metallic tools 4. avoid oils 5. avoid static electricity

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