Medical Gas Therapy - Low-Flow System

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Questions and Answers

What is a characteristic of low-flow oxygen systems?

FiO2 can vary based on the patient's respiratory pattern. (correct)

They fully meet all of a patient's inspiratory demands.

They provide a fixed FiO2 regardless of patient demand.

They are typically used in hyperbaric oxygen therapy.

Which factor does NOT affect the FiO2 estimation in low-flow systems?

Patient's respiratory rate

Flow of gas from the equipment

Presence of oxygen-enriched environments (correct)

Size of the equipment reservoir

What defines a reservoir system in oxygen therapy?

It provides variable FiO2 depending on patient effort.

It can only deliver a maximum of 50% FiO2.

It utilizes an attached reservoir to provide supplemental oxygen. (correct)

It delivers oxygen at a fixed rate to the patient.

Which type of mask is most effective in providing a high and consistent FiO2?

Non-rebreather mask Signup and view all the answers

What is a potential hazard of prolonged exposure to high FiO2 levels?

Development of lung infiltrates Signup and view all the answers

How is troubleshooting of oxygen delivery systems typically approached?

By verifying the oxygen source and flow rate. Signup and view all the answers

What condition is particularly associated with depression of ventilation when using supplemental oxygen?

Chronic obstructive pulmonary disease with chronic hypercapnia Signup and view all the answers

What should practitioners particularly be cautious of in oxygen-enriched environments?

Increased risk of fires Signup and view all the answers

What is the FIO2 level when the port of an incubator is open?

0.40 or less Signup and view all the answers

What major challenge is associated with oxygen tents?

FIO2 is difficult to control due to the tent's large volume. Signup and view all the answers

What happens if there is a pressure change of 10 psig in an oxygen blender?

An alarm will signal the failure of the system. Signup and view all the answers

Which oxygen delivery device provides high FIO2 and positive pressure?

High flow nasal cannula Signup and view all the answers

What is a potential issue when using an incubator for oxygen delivery?

FIO2 can vary significantly if the chamber is opened. Signup and view all the answers

Which type of mask is often used in emergencies for oxygen delivery?

Bag-mask device Signup and view all the answers

What is the primary function of incubators in pediatric care?

To regulate temperature, humidity, and FIO2. Signup and view all the answers

In the context of oxygen delivery, what does FIO2 stand for?

Fraction of Inspired Oxygen Signup and view all the answers

Which device is specifically designed to mix oxygen and air for precise FIO2 delivery?

Oxygen blender Signup and view all the answers

How does a closed port in an incubator affect the FIO2 level?

FIO2 increases to 0.40 or higher. Signup and view all the answers

What is the main FiO2 range provided by a simple mask?

0.35 to 0.50 Signup and view all the answers

What is a significant advantage of using a partial rebreathing mask over a simple mask?

It provides a higher FiO2 capability. Signup and view all the answers

Which of the following describes the primary function of the one-way valves in a nonrebreathing mask?

To prevent the backflow of exhaled air and improve oxygen delivery. Signup and view all the answers

What is a primary goal of oxygen therapy?

To maintain adequate tissue oxygenation Signup and view all the answers

What is one of the common problems that can affect reservoir masks?

Device displacement. Signup and view all the answers

Which condition is an indication for oxygen therapy?

PaO2 less than 60 mm Hg Signup and view all the answers

What is a potential hazard of using FIO2 greater than 50%?

Absorption atelectasis Signup and view all the answers

Which flow range is necessary for a partial rebreathing mask to prevent bag collapse during inspiration?

10 to 15 L/min Signup and view all the answers

Which of the following is an appropriate method to assess a patient's need for oxygen therapy?

Checking arterial blood gas levels Signup and view all the answers

What is one common type of oxygen delivery system?

Low-Flow System Signup and view all the answers

Which mask type is NOT typically used in oxygen therapy?

Sleep apnea mask Signup and view all the answers

How should you respond if an oxygen delivery system malfunctions?

Identify and correct the malfunction promptly Signup and view all the answers

What condition can result from prolonged exposure to concentrations of oxygen above 60 mmHg?

Oxygen toxicity Signup and view all the answers

What is one of the clinical objectives for administering oxygen therapy?

To decrease symptoms associated with chronic hypoxemia Signup and view all the answers

Which of the following is a benefit of implementing protocol-based oxygen therapy?

Standardized approach to treatment Signup and view all the answers

What is the typical flow rate for a nasal cannula?

¼ to 8 L/min Signup and view all the answers

Which factor does NOT affect the FiO2 delivered by a nasal cannula?

Body temperature Signup and view all the answers

What is the FiO2 range typically delivered by a nasal catheter?

0.22 to 0.45 Signup and view all the answers

What is a key characteristic of transtracheal catheters compared to nasal cannulas?

Lower oxygen usage Signup and view all the answers

Which statement about troubleshooting low-flow systems is inaccurate?

The problem with inaccurate flow is greater at higher flow rates. Signup and view all the answers

In which situation would increasing the O2 flow rate not increase FiO2?

When there are high inspiratory flow rates Signup and view all the answers

What is one benefit of using reservoir systems for oxygen delivery?

They can reduce oxygen usage by 50% to 75%. Signup and view all the answers

What is the impact of mouth-open breathing on FiO2 in low-flow systems?

It generally decreases FiO2 levels. Signup and view all the answers

What FiO2 concentration range can be expected at a flow rate of 1 L/min using low-flow systems?

22% to 25% Signup and view all the answers

Which type of oxygen delivery device has been largely replaced by nasal cannulas?

Nasal catheter Signup and view all the answers

Study Notes

Chapter 42: Medical Gas Therapy - Low-Flow System

Learning Objectives (1 of 3):
- Describe when oxygen therapy is needed.
- Assess the need for oxygen therapy.
- Describe precautions and complications associated with oxygen therapy.
- Select an appropriate oxygen delivery system for the respiratory care plan.
Learning Objectives (2 of 3):
- Describe how to administer oxygen to adults, children, and infants.
- Describe how to identify and correct malfunctions of oxygen delivery systems.
- Assess and monitor a patient's response to oxygen therapy.
- Describe how and when to modify or recommend modification of oxygen therapy.
Learning Objectives (3 of 3):
- Describe how to implement protocol-based oxygen therapy.
- Identify indications, complications, and hazards of hyperbaric oxygen therapy.
- Identify when and how to administer specialty therapeutic gases.
Oxygen Therapy:
- Overall goal: Maintain adequate tissue oxygenation and minimize cardiopulmonary work.
- Clinical objectives: Correct documented or suspected acute hypoxemia; decrease symptoms associated with chronic hypoxemia; decrease the workload hypoxemia imposes on the cardiopulmonary system.
Assessing the Need for Oxygen Therapy - Indications:
- Documented or suspected hypoxemia, evidenced by PaO2 less than 60 mm Hg or SaO2 less than 90% on room air.
- PaO2 or SaO2 below the desirable range for a specific clinical situation.
- Severe trauma.
- Acute myocardial infarction (MI).
- Post-operative situations (e.g., post-anesthesia recovery).
Hazards of Oxygen Therapy:
- Ventilatory depression.
- Absorption atelectasis (FIO2 > 50% may cause replacement of nitrogen by oxygen).
- Retinopathy of prematurity (ROP).
- Oxygen toxicity.
- Fire hazard.
- Contamination.
Precautions & hazards of supplemental oxygen (cont.):
- Oxygen toxicity (primarily affects lungs and central nervous system, determining factors include PO2 and exposure time; prolonged exposure to high FIO2 can cause infiltrates in lung parenchyma).
- Depression of ventilation (occurs in COPD patients with chronic hypercapnia).
- Retinopathy of prematurity (excessive blood O2 levels cause retinal vasoconstriction and necrosis).
- Absorption atelectasis (can occur with FIO2 above 0.50, patients breathing small tidal volumes at greatest risk).
Precautions & hazards of supplemental oxygen (cont.) - Fire hazard:
- Fires in O2-enriched environments continue to occur.
- Practitioners in surgery suites & in presence of hyperbaric O2 therapy need to be most careful.
Oxygen Delivery Systems (types):
- Low Flow, Reservoir, and High Flow.
Low-Flow System:
- Description: Variable performance, FiO2 can vary with patient's respiratory rate and pattern, flow of gas from equipment, equipment reservoir, doesn't fully meet patient's inspiratory demands, needs additional mixing with room air.
- Devices: Nasal cannula, nasal catheter (no longer used), transtracheal catheters.
Reservoir Systems (types):
- Cannulas, Masks
- Description: Designed to conserve oxygen, Nasal reservoir, Pendant reservoir; can reduce O2 use by 50%-75%; humidification usually not needed.
- Masks (types): Simple mask, partial rebreathing mask, nonrebreathing mask.
  - Simple mask: input flow 5-10 L/min, FIO2 0.35-0.50, air dilution during inspiration, FiO2 varies depending on the O2 input flow, the mask volume, the extent of air leakage, and the patient's breathing pattern.
  - Partial rebreathing mask: input flow ≥10 L/min to prevent bag collapse, FiO2 range 0.40 to 0.70. Uses no valves.
  - Nonrebreathing mask: More commonly used, input flow ≥10 L/min to prevent bag collapse, FiO2 range 0.60-0.80. One-way valves.
High-Flow:
- Description: Delivers a relatively constant, fixed FiO2 without additional dilution of room air, flow rate adequate to meet patient's needs, based on 60 L/min minimum, or more in specific cases.
- Devices: Air entrainment mask (Venturi mask), Oxygen hoods, Incubators, Oxygen tents, High volume aerosol and humidifiers.
Other Oxygen Delivery Devices: Include but aren't limited to pulse demand systems and oxygen blenders
Troubleshooting: Common problems include inaccurate flow, system leaks and obstructions, device displacement, and skin irritation especially at low-flow settings.
Important Considerations: The choice of delivery system depends on the desired oxygen concentration/FIO2 and the individual patient's needs. Thorough clinical monitoring and assessment of patient response is necessary.

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Description

This quiz covers the essential concepts and practices of medical gas therapy, specifically focusing on low-flow oxygen systems. It includes objectives related to the assessment and administration of oxygen therapy for different patient populations, as well as the identification of potential complications and system malfunctions. Test your knowledge on the application and protocols of oxygen therapy to ensure effective respiratory care.