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38 Cards in this Set
- Front
- Back
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Specific clinical objectives for Oxygen therapy are?
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1. Correct documented or suspected acute Hypoxemia
2. Decrease the symptoms associated with chronic hypoxemia 3. Decrease the WL hypoxemia imposes on the Cardio-Pul. system |
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How does Oxygen correct Hypoxemia?
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By raising alveolar and blood levels of oxygen.
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How does C-P system compensate for Hypoxemia?
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By increasing ventilation and C.O.
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What are some of the advantages of Supplemental O2?
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1. Relieve dyspnea with COPDer
2. Improve mental function 3. decrease demand on the heart and lungs. 4. Reduce High ventilatory demand and WOB. |
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What does Hypoxemia Cause?
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Vasoconstriction
Pulmonary hypertenstion. |
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Pulmonary vasoconstriction and Hypertension increase workload on which side of heart?
a. Right B. Left |
Right
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Indications for O2 therapy?
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1. Documentated Hypoxemia
Adults, children, and infants >28days: PaO2 <60mmhg or SaO2 <90% Neonates: PaO2 <50mmhg,SaO2 <88% 2. Acute care situations in which hypoxemia is suspected 3. Severe Tramua 4. AMI 5. Short-term therpay |
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If O2 is needed for hypercapnic patients, what PaO2 levels may depress the ventialtory drive?
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PaO2 >60mmHg
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FIO2> 60% for long-period of time can cause what complications in patients?
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1. Absorption Atelectasis
2. Oxygen toxicity 3. ciliary or leukocyte depression |
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In Pre-mies, what PaO2 levels can cause ROP?
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PaO2 levels >80mmHg.
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Why is important to watch high O2 levels with paients who have Ductal heart Lesions?
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It could close or constrict the Ductus Arterious.
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What 3 physiologic parameters should be monitored with O2 therpay?
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PaO2, SaO2, SpO2
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When initiating O2 therpay for COPDer, when should you check the status of that patient O2 ?
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within 2hours of starting therapy
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How often should you check O2 delivery systems?
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Daily
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What are 3 basic ways to determine the need for Oxygen therapy?
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1. LAB TEST (ABG)
2. CLINICAL PRESENTATION 3. symptoms of cyanosis, tachypnea, distressed appearance |
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What are examples of patients who need O2 therapy do to hypoxemia?
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1. post- op patiens
2. CO poisoning (high mmHg) 3. Cyanide poisoning 4. shock 5. trauma 6. AMI |
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Oxygen Toxicity primarily affects what 2 systems?
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Pulmonary (lungs)and CNS.
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What 2 primary factors determine the harmful effects of oxygen?
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1. PO2
2. exposure time |
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O2 toxicity effects the CNS how?
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1. tremors
2. twitching, 3. Convulsions |
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Patients with High PO2 for a prolonged exposure has symptoms of ?
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Bronchopneumonia
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Some clincial findings with Prolonged O2 exposure?
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1. Patchy infiltrates and usually are most prominent in the lower lung fields
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What are some physicogical effects of long O2 exposure?
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1. Capillary endothelium damage
2. Interstital edema 3. thickens the A-C membrane 4. type I alveolar cells are destroyed 5. type II cells proliferate. |
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What follows the Exudative stage of Long O2 exposure?
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1. Low V/Q mismatch
2. Physiological shunting 3. hypoxemia |
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In the end stages of O2 exposure, what are the under affects?
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Hyaline membrane forms, with pulmonary fibrosis and hypertension develop.
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Oxygen free radicals are byproduct of what?
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cellular metabolism
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What protects us from this free radicals?
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Superoxide dismutase
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What are some antioxidants that protect us from free radicals?
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Vit. E, C and Beta-carotene.
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During Oxygen toxicity cell damage occurs which causes a immune response. In return does what to the Pulmonary system?
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Causes tissue infiltration by Neutophils and Macrophages.
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A RULE OF THUMB, what is the limited time a patient can be exposed to HIGH O2?
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100% oxygen to less than 24 hours.
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What is the goal of titrating O2?
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70% in 2 days; and 50% within 5 days.
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For infants, what are the 2 main diseases that with form with High O2 levels?
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Retinopathy of prematurity
Bronchopulmonary dysplasia |
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Decrease in ventilation of nearly _______ have been observed IN COPDer when PaO2 increase by how much?
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20%; and 20-23mmHg
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With COPDer's, what is blunted and the primary stimulus to breathe is?
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CO2; O2
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High blood levels in COPDers may do what?
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disrupt normal V/Q balance and cause an increase in dead space to tidal volume (Vds/Vt) ratio and increase in PaCO2.
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Describe the affects of high oxygen blood levels in pre-mies?
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Cause retinal vasoconstriction, which leads to necrosis of the blood vessels. Which leads to scaring and retinal detachment and blindness
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At what age does ROP affect neonates?
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up to Approximately 1 month of age.
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What are some other underlying factors contributing to ROP of the Newborn?
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Hypercapnia, hypocapnia, intraventricular hemorrhage, infection, lactic acidosis, anemia, hypcalemia and hypothermia
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The risk of absorption atelectasis is greatest when?
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Patients breathing low Vt as a result of sedation, surgical pain or CNS dysfunction.
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