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RCP 120 Exam 2
| Term | Definition |
|---|---|
| Know and understand when to use HME vs Heated wire humidification. | Heated used when patient has bloody secretions, thick tenacious sputum, or core temp is less 32 C. More than 4 HMEs used in 24 hours |
| Know and understand an oxygen analyzer. | Used to measure O2 concentration administered to patients |
| A physician orders bland water aerosol administration to a patient with a tracheostomy. What devices could you use to meet this goal? | Large volume nebulizer w/ trach mask/collar and t-piece |
| When using a nasal cannula, what device helps with nasal dryness and irritation? | Bubble humidifier |
| What is a Passover humidifier? | Air passes over the water |
| What is a bubble humidifier? | Directs gas through the water to create humidification |
| What is an HME? | Heat and moisture exchanger, which captures heat and condensation from exhalation |
| Know and understand the FI02 equation | [(Air flow x 21) + (O2 flow x 100)] / total gas flow |
| Compressed air | Characteristics: Colorless, Odorless, tasteless, supports life, nonflammable/supports combustion Uses: Dilutes 100% O2, driving gas for breathing when not using O2 Color: Yellow |
| Oxygen | Characteristics: Colorless, odorless, tasteless, supports life, nonflammable/supports combustion Uses: perioperative conditions, COPD, ARDS, CPR, MI, cardiogenic pulmonary edema, corpulmonale, carbon monoxide and traumatic brain injury Color: Green |
| Carbogen | Characteristics: Colorless odorless/can be pungent tasteless/can be slightly acidic does not support life nonflammable Uses: Treats hiccups atelectasis, retinal revascularization anxiety-related hyperventilation and cerebrovascular conditions Color:Gray |
| Know the total flow equation | Determine the air:O2 ratio, then add the air:O2 ratio together and then divide the total gas by the total number of parts, next multiply the L/min per part by the number of parts of O2 and air, add the L flow together to get the total flow |
| Know how to determine air:o2 ratio | 100 - FiO2 / FiO2 - (21 if less than 35, 20 if 35 or greater) |
| Know how to determine a patients flow rate and device flow rate | Determine the air:O2 ratio, then multiply by L/min, then add the L/min, L/min of device must exceed patients needs |
| What are the major precautions or hazards of supplemental oxygen therapy? | O2 toxicity, Hyperoxemia, nitrogen washout, O2 induced hypoventilation (COPD), retinopathy of prematurity, closure of ductus arteriosus, combustion |
| What are the different names for compressed air | Room air and ambient air |
| What does the + marking on a gas tank mean? | Increased tank 10% above normal pressure, tank can hold 10% more pressure and won't bust |
| When do we recommend bland aerosol therapy administration? | Artificial airway, relieve an edematous airway, sputum induction, thin secretions that are thick and tenacious |
| How can the hospital gas distribution alarm be turned off? | When the situation is corrected |
| How often should heat-moisture exchangers be inspected and replaced? | Should not be changed more often than every 48 hours/ change when secretions accumulate |
| What areas are zone valves required? | Nurseries, emergency department, ICU, and anesthetizing locations (Not in patient rooms) |
| Know and understand PA-a02. | PAO2- alveolar partial pressure, PaO2- arterial partial pressure normal:5-15 |
| Oxygen analyzers use what to measure oxygen concentration? | FiO2 |
| What is the difference between fixed and variable oxygen devices | Variable- can not be 100% sure about the FiO2 is being delivered Fixed- Can be “dialed in” and the flow rate will not affect the FiO2 |
| What are ways a gas tank can be identified? | Color and label |
| What conditions may oxygen therapy be of limited value | Anemia, low cardiac output, and shunt |
| Venturi Mask | L/min: Depends on the FiO2 delivered and the flow requirements of the patient FiO2: 24-55% |
| Gas tank duration | (Gauge pressure (psig) - 500) x cylinder factor / O2 flow rate (L/min) |
| What is hyperbaric and when is it used | Chamber where atmospheric pressure increased to treat (insert long list here) with O2 |
| 80/20 heliox equation | Multiply the flow by 1.8 |
| 70/30 heliox equation | Multiply the flow by 1.6 |
| What is the greatest potential problem with quick-connect DISS systems? | Not interchangeable, i.e. only certain adapters fit into the wall |
| What oxygen delivery device is used to administer Heliox therapy? | Non-rebreathing mask |
| What are the clinical goals and objectives for oxygen therapy? | Correct documented or suspected acute hypoxemia, Decrease symptoms associated with chronic hypoxemia, Decrease the work load that hypoxemia imposes on cardiopulmonary system |
| What are the primary uses for compressed air? | Dilute 100% air, driving gas for breathing treatments for patients who don’t need O2 |
| What can alter the FI02 delivered by nasal cannula? | Tachypnea, nasal obstruction, and mouth breathing |
| What can be used efficiently to deliver medication to a patient with a tracheostomy? | Small volume neb and MDI |
| What can be used to deliver aerosols during noninvasive ventilation? | Small volume neb and MDI |
| What is a flow restrictor? | DISS adapter that has a specific liter flow and can’t be changed |
| What is defined as low level of oxygen in the blood? | Hypoxemia |
| What types of patients might have difficulty using a pressurized metered-dose inhaler (pMDI)? | COPD, patients who can’t generate the necessary inspiratory force |
| What are regulators? | Respiratory equipment that is calibrated for 50 psigs (working pressure, part of a safety system to ensure proper administration of medical gases |
| While breathing with a non-rebreather, you notice that the patient's reservoir bag completely collapses on inspiration. What should you do? | Increase the flow |
| Heliox | Characteristics: Colorless, Odorless, tasteless, does not support life, nonflammable Uses: Post extubation stridor, severe asthma, obstructive tumors, foreign object aspiration, partial vocal cord paralysis |
| Nitric Oxide | Characteristics: Colorless, Slightly metallic odor, tasteless, does not support life, nonflammable Uses: Primary pulmonary hypertension, refractory hypoxemia, increase pulmonary vascular resistance, right heart failure |
| Gas tank equation for liquid | (Liquid O2 capacity) x (860) x (gauge reading %) / O2 flow rate |
| Gas tank equation for lbs | (Weight of liquid O2 remaining (lbs)) x 344 L of gas/lb / O2 flow rate |
| E tank cylinder factor | 0.28 L/psig |
| H/K tank cylinder factor | 3.14 L/psig |
| Simple mask | L/min: 6-10 FiO2: 40-60% |
| Partial re-breather mask | L/min: 6-10 FiO2: 60-65% |
| Non-rebreather mask | L/min: 10-15 FiO2: 60-100% |
| Oxymizer | L/min: 1-10 FiO2: 24-60% |
| Nasal Cannula | L/min: 1-6 FiO2: 24-44% |
| Aerosol trach mask | L/min: Depends on the FiO2 delivered and the flow requirements of the patient FiO2: 21-40% |
| Aerosol t-piece | L/min: Depends on the FiO2 delivered and the flow requirements of the patient FiO2: 21-100% |
| Aerosol face tent | L/min: Depends on the FiO2 delivered and the flow requirements of the patient FiO2: 21-40% |
| Aerosol face mask | L/min: Depends on the FiO2 delivered and the flow requirements of the patient FiO2: 21-100% |
| Oxymask | L/min: 1- flush FiO2: 24-90% |
Created by:
K.Moskowitz
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