Neonate/Ped's Oxygenation and CPAP

In children up to the age of 6 months, the interface most commonly used to proved CPAP is the A. nasal prongs B. nasal mask C. oronasal mask D. nasal trumpet

A. nasal prongs

When the Bubble CPAP system is in use, the desired CPAP level is set by A. increasing flow from the gas source B. adjusting the position of the CPAP probe C. increasing the generators pressure D. increasing the CPAP setting

B. adjusting the position of the CPAP probe

A 7 yr old patient on the general peds floor becomes a primary mouth-breather while asleep, resulting in a drop in SpO2 from 95% to 87% while on 3 L/min nasal cannula. The best remedy while asleep is to A. apply CPAP with oxygen bleed-in. B. change to a 30% air-entrainment mask. C. place the cannula in the patient's mouth. D. apply a chin strap.

B. change to a 30% air-entrainment mask

What is most indicated if the infant is grunting? a. regular nasal cannula b. cpap c. oxyhood d. croup tent

B. cpap

A 2-year-old child with asthma and pneumonia is in the emergency department in severe respiratory distress. The patient is receiving oxygen therapy by high-flow air entrainment mask set at FIO2 0.5. Despite bronchodilation efforts, distress continues. The patient has an SpO2 of 88% and is exhibiting expiratory grunting. Which of the following is an appropriate recommendation? A. intubate and mechanically ventilate the patient B. switch to a high-flow nasal cannula (HFNC) C. change to a partial rebreather mask at 8 L/min D. implement ECMO

B. switch to a high flow nasal cannula A high-flow nasal cannula is an effective way to provide supplemental oxygen, high humidity, and continual positive airway pressure. This will help oxygenate the patient while decreasing the work of breathing.

Which of the following is a goal for oxygen therapy? A. improve gas distribution in the lungs B. decrease V/Q mismatching C. decrease cardiac work requirement D. improve cardiac efficiency

C. decrease cardiac work requirement There are three main goals to oxygen therapy: 1) decrease work of breathing, 2) resolve or decrease hypoxemia, 3) decrease cardiac work requirement.

Six minutes after delivery, a newborn has APGAR scores of 2 and 6. What is the next best course of action? A. Intubate and provide mechanical ventilation. B. Warm the heel for a capillary draw. C. Provide oxygen and reassess D. Perform cardiopulmonary resuscitation.

C. provide oxygen and reassess

What modality is best to deliver Heliox 70/30 A. nasal cannula B. simple mask C. air entrainment mask D. nonrebreather mask

D. nonrebreather mask

A 14-year-old patient, with a history of asthma, is brought to the emergency room (ER) by the paramedics. The reports indicates the patient is wheezing bilaterally and is only able to speak in one-word-sentences. The patient is receiving oxygen by nasal cannula at 2 L/min. The initial action of the respiratory therapist should be to A. Increase oxygen flow rate to 4 L/min B. Adminsiter Solu-Mederol, IV C. Administer a breathing treatment with Abluterol and Ipratropium Bromide (Atrovent) D. Switch to a nonrebreathing mask

D. switch to a nonrebreathing mask When a patient is only able to speak in one word sentences, the degree of ventilatory compromise is severe. This is considered an emergency situation, according to national asthma guidelines. In such a case, the situation must be treated as an emergency and the patient should receive 100% oxygen. A non-rebreathing mask is most appropriate.

High flow humidified nasal cannula can provide a level of CPAP for infants. True False

True

What pressure of cpap should not be exceeded with a newborn? a. 8 b. 5 c. 10 d. 12

a. 8

Your neonate patient is in an oxyhood with an FiO2 of 30%. The nurse calls you because the baby is fussy and can't sleep. What should you do? a. Set up a blender on 30% with a large volume nebulizer at 100% b. Switch to a croup tent c. Switch to a 2.5% nasal cannula d. Switch to nasal cpap

a. Set up a blender on 30% with a large volume nebulizer at 100%

What type of interfact is most often used with a cpap for a neonate? a. nasal/prong mask b. oronasal c. full face/jason mask d. oxymask

a. nasal/prong mask

Where should the oxygen be analyzed when using an oxyhood? a. near the infants mouth b. at the top of the oxyhood c. outlet where large bore tubing is d. very bottom of the oxyhood

a. near the infants mouth

When should the RT recommend CPAP on a neonate? a. When the infant is not responding to an increased FiO2 (over 60%) b. Once the FiO2 is over 80% c. When the FiO2 is at 100% d. When the patient presents with sternal retractions

a. when the infant is not responding to an increased FiO2 (over 60%)

What is the most common method of oxygen to deliver to a newborn? a. nasal cannula b. oxyhood c. oxygen hood d. aerosol mask

b. oxyhood

What is most indicated if the infant is grunting? a. regular nasal cannula b. oxyhood c. high flow humidified nasal cannula d. croup tent

c. high flow humidified nasal cannula

What is a common problem with low FiO2 attached to a large volume nebulizer, attached to an oxyhood on a neonate patient? a. too high of humidity b. temperature control c. too loud d. hypercapnia can be an issue

c. too loud

What is the best cpap pressure to start off at for a newborn? a. 5-8 b. 10 c. 1-3 d. 2-5

d. 2-5

What is the therapeutic FiO2 range for a neonate? a. 21-30% b. 50-70% c. 100% d. 30-60%

d. 30-60%

3 main goals of oxygen therapy:

1. Decrease work of breathing 2. resolve or decrease hypoxemia 3. decrease cardiac work requirement