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RCP 120 Exam 2

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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