FRT PREFINAL

46問 • 1年前

Mekayla Absara

通報

問題一覧

is the most common mode of respiratory care.

Gas therapy

maintain adequate tissue oxygenation while minimizing cardiopulmonary work.

goal of O2 therapy

- O2 therapy corrects hypoxemia by increasing alveolar and blood levels of O2. - is the most tangible objective of O2 therapy and the easiest to measure and document.

Correcting Hypoxemia

- O2 therapy can help relieve the symptoms associated with certain lung disorders, including dyspnea. - O2 therapy also may improve mental function among patients with chronic hypoxemia.

Decreasing Symptoms of Hypoxemia

The cardiopulmonary system compensates for hypoxemia by increasing

COMPENSATION

supplemental O2 can decrease demands on both the heart and the lungs.

Acute hypoxemia –

can maintain acceptable tissue oxygenation only by increasing cardiac output or, if the hypoxemia is chronic, by increasing the red blood cell mass.

Patients with arterial hypoxemia

this increased workload over the long term can lead to right ventricular failure (cor pulmonale).

Patients with chronic hypoxemia

less than 55 – 60 mm Hg

PaO2

- The condition formerly known as oxygen toxicity.

Hyperoxic acute lung injury

- defined as PaO2 greater than 300 mm Hg.

Hyperoxia

appear on chest x-rays and usually are most prominent in the lower lung fields.

Patchy infiltrates

- free radicals can overwhelm the body’s normal antioxidant system and cause cell damage.

Presence of high PaO2

- is associated with retinopathy of prematurity (ROP) and bronchopulmonary dysplasia in infants.

High PO2

Decreases in ventilation of nearly 20% have been observed in these patients with accompanying elevations in arterial partial pressure of carbon dioxide (PaCO2) of 20 to 23 mm Hg.

DEPRESSION OF VENTILATION

- also called retrolental fibroplasia.

RETINOPATHY OF PREMATURITY

- often involves the administration of supplemental O2 and greatly increases fire risk.

Hyperbaric oxygen (HBO) therapy

- the most commonly used oxygen delivery device.

Nasal cannula (low flow) (1 – 5 L/min)

- are almost exclusively used for limited, short-term O2 administration during specialized procedures such as a bronchoscopy.

Nasal catheters

transtracheal O2 catheter is a thin polytetrafluoroethylene (Teflon) catheter inserted into the trachea between the second and third tracheal rings.

Transtracheal catheter

- incorporate a mechanism for gathering and storing O2 between patient breaths. - Patients draw on this reserve supply whenever inspiratory flow exceeds O2 flow into the device.

RESERVOIR SYSTEMS

are designed to conserve O2 and are an alternative to the pulse-dose or demand-flow O2 systems.

Reservoir cannulas

- helps overcome esthetic concerns by hiding the reservoir under the patient’s clothing on the anterior chest wall.

Pendant reservoir system

are the most commonly used reservoir systems.

RESERVOIR MASKS

a disposable plastic unit designed to cover both the mouth and the nose.

Simple mask

- has no valves - During inspiration, source O2 flows into the mask and passes directly to the patient. - During exhalation, source O2 enters the bag.

Partial rebreathing mask

- Commonly used than a partial rebreathing mask, prevents rebreathing with one-way valves.

nonrebreathing mask

- use air-entrainment or gas blending, and supply a given O2 concentration at a flow equaling or exceeding the patient’s peak inspiratory flow.

HIGH-FLOW SYSTEMS

- direct a high-pressure O2 source through a small nozzle or jet surrounded by air-entrainment ports.

AIR-ENTRAINMENT SYSTEMS

History)The use of an O2 mask with controlled FiO2 by means of air entrainment was first reported in 1941 by Barach and Eckman.

Air-entrainment (venturi) mask

is achieved through production of aerosol at the nebulizer jet.

Humidification

is provided by an optional heating element.

2. Temperature control

- popular for pediatric and neonatal patients with disorders including bronchiolitis and bronchopulmonary dysplasia.

High-flow nasal cannula (HFNC)

- allows precise control over both FiO2 and total flow output.

Blending systems

- When gases are mixed manually, separate air and O2 flowmeters must be adjusted for the desired FiO2 and flow.

Mixing gases manually

Rather than manually mixing air and O2, the RT more often uses an O2 blender.

Oxygen blenders

- is among the oldest approaches to O2 therapy.

Enclosures

- use a self-inflating bag and nonrebreathing valve features to provide up to 100% O2 - are often used in emergency life support

Bag-mask devices

Patient in semi-Fowler's position with head of the bed raised 45 degrees

Apical segments of right and left upper lobes:

Patient supine with the bed flat

b. Anterior segments of both upper lobes

Patient one-quarter turn from prone with the right side up, supported by pillows, and with head of the bed flat

c. Posterior segments of right upper lobe

Patient one-quarter turn from prone with the left side up, supported by pillows, and with head of the bed elevated 30 degrees

d. Apical-posterior segment of left upper lobe

Patient one-quarter turn from supine with right side up and foot of the bed elevated 12 in.

e. Medial and lateral segments of right middle lobe

Patient one-quarter turn from supine with left side up and foot of the bed elevated 12 in.

f. Superior and inferior segments of lingula:

: Patient prone with head of the bed flat and pillow under the abdominal area

g. Superior segments of both lower lobes

Patient supine, with foot of the bed elevated 20 in

h. Anteromedial segment of left lower lobe and anterior segment of right lower lobe

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問題一覧

is the most common mode of respiratory care.

Gas therapy

maintain adequate tissue oxygenation while minimizing cardiopulmonary work.

goal of O2 therapy

- O2 therapy corrects hypoxemia by increasing alveolar and blood levels of O2. - is the most tangible objective of O2 therapy and the easiest to measure and document.

Correcting Hypoxemia

- O2 therapy can help relieve the symptoms associated with certain lung disorders, including dyspnea. - O2 therapy also may improve mental function among patients with chronic hypoxemia.

Decreasing Symptoms of Hypoxemia

The cardiopulmonary system compensates for hypoxemia by increasing

COMPENSATION

supplemental O2 can decrease demands on both the heart and the lungs.

Acute hypoxemia –

can maintain acceptable tissue oxygenation only by increasing cardiac output or, if the hypoxemia is chronic, by increasing the red blood cell mass.

Patients with arterial hypoxemia

this increased workload over the long term can lead to right ventricular failure (cor pulmonale).

Patients with chronic hypoxemia

less than 55 – 60 mm Hg

PaO2

- The condition formerly known as oxygen toxicity.

Hyperoxic acute lung injury

- defined as PaO2 greater than 300 mm Hg.

Hyperoxia

appear on chest x-rays and usually are most prominent in the lower lung fields.

Patchy infiltrates

- free radicals can overwhelm the body’s normal antioxidant system and cause cell damage.

Presence of high PaO2

- is associated with retinopathy of prematurity (ROP) and bronchopulmonary dysplasia in infants.

High PO2

Decreases in ventilation of nearly 20% have been observed in these patients with accompanying elevations in arterial partial pressure of carbon dioxide (PaCO2) of 20 to 23 mm Hg.

DEPRESSION OF VENTILATION

- also called retrolental fibroplasia.

RETINOPATHY OF PREMATURITY

- often involves the administration of supplemental O2 and greatly increases fire risk.

Hyperbaric oxygen (HBO) therapy

- the most commonly used oxygen delivery device.

Nasal cannula (low flow) (1 – 5 L/min)

- are almost exclusively used for limited, short-term O2 administration during specialized procedures such as a bronchoscopy.

Nasal catheters

transtracheal O2 catheter is a thin polytetrafluoroethylene (Teflon) catheter inserted into the trachea between the second and third tracheal rings.

Transtracheal catheter

- incorporate a mechanism for gathering and storing O2 between patient breaths. - Patients draw on this reserve supply whenever inspiratory flow exceeds O2 flow into the device.

RESERVOIR SYSTEMS

are designed to conserve O2 and are an alternative to the pulse-dose or demand-flow O2 systems.

Reservoir cannulas

- helps overcome esthetic concerns by hiding the reservoir under the patient’s clothing on the anterior chest wall.

Pendant reservoir system

are the most commonly used reservoir systems.

RESERVOIR MASKS

a disposable plastic unit designed to cover both the mouth and the nose.

Simple mask

- has no valves - During inspiration, source O2 flows into the mask and passes directly to the patient. - During exhalation, source O2 enters the bag.

Partial rebreathing mask

- Commonly used than a partial rebreathing mask, prevents rebreathing with one-way valves.

nonrebreathing mask

- use air-entrainment or gas blending, and supply a given O2 concentration at a flow equaling or exceeding the patient’s peak inspiratory flow.

HIGH-FLOW SYSTEMS

- direct a high-pressure O2 source through a small nozzle or jet surrounded by air-entrainment ports.

AIR-ENTRAINMENT SYSTEMS

History)The use of an O2 mask with controlled FiO2 by means of air entrainment was first reported in 1941 by Barach and Eckman.

Air-entrainment (venturi) mask

is achieved through production of aerosol at the nebulizer jet.

Humidification

is provided by an optional heating element.

2. Temperature control

- popular for pediatric and neonatal patients with disorders including bronchiolitis and bronchopulmonary dysplasia.

High-flow nasal cannula (HFNC)

- allows precise control over both FiO2 and total flow output.

Blending systems

- When gases are mixed manually, separate air and O2 flowmeters must be adjusted for the desired FiO2 and flow.

Mixing gases manually

Rather than manually mixing air and O2, the RT more often uses an O2 blender.

Oxygen blenders

- is among the oldest approaches to O2 therapy.

Enclosures

- use a self-inflating bag and nonrebreathing valve features to provide up to 100% O2 - are often used in emergency life support

Bag-mask devices

Patient in semi-Fowler's position with head of the bed raised 45 degrees

Apical segments of right and left upper lobes:

Patient supine with the bed flat

b. Anterior segments of both upper lobes

Patient one-quarter turn from prone with the right side up, supported by pillows, and with head of the bed flat

c. Posterior segments of right upper lobe

Patient one-quarter turn from prone with the left side up, supported by pillows, and with head of the bed elevated 30 degrees

d. Apical-posterior segment of left upper lobe

Patient one-quarter turn from supine with right side up and foot of the bed elevated 12 in.

e. Medial and lateral segments of right middle lobe

Patient one-quarter turn from supine with left side up and foot of the bed elevated 12 in.

f. Superior and inferior segments of lingula:

: Patient prone with head of the bed flat and pillow under the abdominal area

g. Superior segments of both lower lobes

Patient supine, with foot of the bed elevated 20 in

h. Anteromedial segment of left lower lobe and anterior segment of right lower lobe