RCP 120 Exam 2 Review

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Questions and Answers

Which of the following is NOT an indication for oxygen therapy?

Tachycardia

Bradycardia (late)

Change of mental status

Normal SpO2 reading (correct)

What is the recommended practice regarding the duration of 100% oxygen therapy?

It is safe for continuous use as needed.

It should be limited to 48 hours or less.

It should be limited to 24 hours or less. (correct)

It should be administered indefinitely.

What is the primary difference between ventilation and oxygenation?

Ventilation is the movement of air; oxygenation is the amount of oxygen in the tissues. (correct)

There is no significant difference; they are often used interchangeably.

Ventilation involves gas exchange; oxygenation refers to the transport of oxygen in the blood.

Ventilation refers to oxygen therapy; oxygenation is done through artificial means.

In patients with COPD, what is the normal SpO2 range that can often be considered acceptable?

88% or even less Signup and view all the answers

Why is it important to maintain FiO2 at 50% or less when possible?

To prevent oxygen toxicity and other complications. Signup and view all the answers

What is the correct formula to calculate Flow Demand for a patient?

Flow Demand = Minute Ventilation x 3 Signup and view all the answers

If a patient's Minute Ventilation is calculated to be 10 liters per minute, what is their Flow Demand?

30 liters per minute Signup and view all the answers

Which formula accurately determines the flow setting on a flowmeter needed to achieve a specified Total Flow?

Flow = Total Flow / Ratio Parts Signup and view all the answers

What does 'Total Flow' measure in the context of respiratory therapy?

The total liters of air or oxygen a device administers to a patient Signup and view all the answers

What is the primary variable used in the Total Flow formula?

Ratio Parts Signup and view all the answers

What is the primary difference between hypoxemia and hypoxia?

Hypoxemia refers to low oxygen levels in the blood plasma, while hypoxia refers to low oxygen levels delivered to tissues. Signup and view all the answers

What is the normal level for SpO2 as measured by pulse oximetry?

92% or higher Signup and view all the answers

At what range is mild hypoxemia defined according to SaO2 levels?

60 to 79 mmHg Signup and view all the answers

Which of the following best describes hyperbaric oxygen therapy?

Delivery of 100% oxygen under increased pressure, sometimes up to 3 atm. Signup and view all the answers

Which of the following statements is NOT true regarding oxygenation?

PaO2 measures the total oxygen content bound to hemoglobin. Signup and view all the answers

What happens to oxygen release from hemoglobin during a right shift of the oxyhemoglobin dissociation curve?

Oxygen is released more easily to cells. Signup and view all the answers

Which of the following statements accurately describes atelectasis?

It involves the collapse of the alveoli. Signup and view all the answers

Which type of mask is capable of supplying all of a patient's inspiratory flow demands?

Non-Rebreather Mask (NRB Mask) Signup and view all the answers

Which of the following characteristics is specific to high flow devices in respiratory support?

They supply all of the patient's inspiratory flow demand. Signup and view all the answers

Which of the following factors does NOT affect the accuracy of pulse oximetry measurements?

Temperature of the patient Signup and view all the answers

What impact does a decrease in temperature have on the affinity of hemoglobin for oxygen, according to the oxyhemoglobin dissociation curve?

It increases the affinity for oxygen. Signup and view all the answers

What is the main purpose of measuring SpO2 in patients?

To evaluate the oxygen saturation levels in the blood Signup and view all the answers

Which low flow device does NOT provide sufficient inspired gas flow on its own during respiration?

Nasal Cannula Signup and view all the answers

Which statement about air entrainment ratios is incorrect?

Higher air entrainment ratios mean more O2 intake. Signup and view all the answers

What is the primary caution to consider when interpreting pulse oximetry results?

The importance of assessing the patient rather than relying solely on the pulse oximeter Signup and view all the answers

Study Notes

Indications for Oxygen Therapy

Key symptoms: cyanosis, tachycardia, bradycardia (late stage), tachypnea, change in mental status, lethargy.
Pulse oximetry reading consistently below 92% indicates need for therapy, dependent on individual patient circumstances.

Basic Oxygen Therapy Procedures

Limit use of 100% oxygen to a maximum of 24 hours to avoid toxicity.
Ideal target is to maintain the Fraction of Inspired Oxygen (FiO2) below 50%.
Normal oxygen saturation (SpO2) levels in adults range from 92% to 99%, while COPD patients may function well at 88% or lower.

Ventilation vs. Oxygenation

Distinction: ventilation is the physical act of breathing, including inspiration and exhalation; oxygenation refers to oxygen delivery to tissues.
It is possible for a patient to ventilate adequately but have poor oxygenation.

SpO2 vs. SaO2 vs. PaO2

SpO2: oxygen saturation measured with pulse oximetry; normal is 92% and above.
SaO2: oxygen saturation from arterial blood gas (ABG); normal range between 80-100 mmHg.
- Mild hypoxemia: 60-79 mmHg
- Moderate hypoxemia: 40-59 mmHg
- Severe hypoxemia: less than 40 mmHg
PaO2: partial pressure of oxygen in arterial blood plasma.

Hypoxemia vs. Hypoxia

Hypoxemia is characterized by low oxygen levels in the blood plasma.
Hypoxia refers to inadequate oxygen delivery to body tissues.

Hyperbaric Oxygen Therapy

Administers 100% oxygen under pressure, potentially up to 3 atmospheres.
Key benefits include enhanced wound healing.

Respiratory System Terms

Atelectasis

Refers to the collapse of a lung or its alveoli.
Absorption atelectasis occurs when oxygen replaces nitrogen in the alveoli, leading to collapse.

Oxyhemoglobin Dissociation Curve

Illustrates the relationship between SaO2 and PaO2.
Right Shift: occurs with increased CO2, lower pH (acidosis), 2,3 DPG, and elevated temperature resulting in lower affinity for O2; facilitates O2 release.
Left Shift: occurs with decreased CO2, higher pH (alkalosis), lower 2,3 DPG, and reduced temperature, increasing O2 affinity and complicating release to cells.

Low Flow vs. High Flow Devices

Low Flow: does not provide sufficient inspiratory flow demand; includes nasal cannula, oxymask, and simple mask.
High Flow: meets inspiratory flow demand; includes aerosol mask, venti mask, and non-rebreather (NRB) mask.

Pulse Oximetry

Measures SpO2 using a sensor that detects red and infrared light; reliable readings may be affected by nail polish, strong external lights, hypothermia, poor perfusion, and skin tone.

Treatment Principle

Priority should be focused on treating the patient instead of solely relying on pulse oximetry values.

Air Entrainment Ratios

Defines the relationship between the amount of ambient air and oxygen inhaled by a patient.
Calculations can be made using specific formulas.

Minute Ventilation

Total volume of air or oxygen inhaled per minute; calculated with the formula: Ve = RR x Vt (Respiratory Rate x Tidal Volume).

Total Flow

Total volume of air or oxygen delivered to a patient; calculated as: Total Flow = Ratio Parts x Flow (where Ratio Parts is the sum of air entrainment ratios).

Flow Demand

Represents the patient’s airflow needs; determined by the formula: Flow Demand = Minute Ventilation x 3.

Flow Meter Settings

Determines how to adjust a flowmeter to achieve a specified total flow: Flow = Total Flow / Ratio Parts.

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Description

This quiz covers essential topics in respiratory care, focusing on indications for oxygen therapy and basic procedures. Prepare for your RCP 120 Exam with questions about patient assessment, therapy guidelines, and critical care protocols relevant for Fall 2024.

RCP 120 Exam 2 Review - Fall 2024