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Neonatal Pediatric Respiratory Equipment questions with answers.
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Neonatal Pediatric RespiratoryEquipment questions with answers.
What does transcutaneous blood gas monitoring allow? ANS - constant monitoring of the patient's
PaO2 and PCO2 without the need of continuously drawing blood gases
transcutaneous blood gas measurements ANS - PaO2 as PtcO2
PCO2 as PtcCO2
transcutaneous monitors differ from saturation monitors ANS - they heat the skin to help arterialize the
capillaries beneath the skin and increase the permeability of the skin to O2 and CO2 allowing the gases
to more readily diffuse to the sensor
What factors influence transcutaneous blood gas monitors? ANS - age
perfusion status (vasoconstriction/dehydration, low cardiac output)
Why are premature infants, neonates, and children have the greatest accuracy as far as transcutaneous
blood gas monitors? ANS - due to the composition of their skin which makes it easier to detect changes
indications of PtcCO2 ANS - hemodynamically stable in need for PaCO2 monitoring but having issues
either collecting blood or with low Hb counts
diagnostic purposes
How can transcutaneous monitoring be used for diagnostic purposes? ANS - in assessment of
functional shunts or a patient's response to an oxygen challenge to determine congenital heart disease
contraindications and precautions of transcutaneous monitoring ANS - thermal damage to the skin due
to the heating of the skin
false negative leading to false statement
values need to be trended against blood gas values in some cases to assure accuracy of readings
, values can vary greater than 10% in some areas even with proper probe placement
prevention of thermal damage during transcutaneous monitoring ANS - reposition electrode every 2-
6hrs
stabilization of values can take up to 20mins after moving the electrode
nitric oxide (NO) ANS - selective pulmonary vasodilator used to treat newborns who require mechanical
ventilation primarily for hypoxic respiratory failure
How does NO work? ANS - improves shunts created by our bodies' natural ability to constrict
pulmonary vasculature local to the alveoli that are not being well-ventilated or oxygenated
vasodilation of constricted capillaries surrounding healthy alveoli with NO ANS - helps overcome
shunting occurring in the lungs
effects for iNO ANS - improves oxygenation
reduces the need for extracorporeal membrane oxygenation
normal starting dose of iNO ANS - 20 ppm
therapeutic range of iNO ANS - 2-20 ppm
NO + oxygen ANS - forms toxic nitrogen dioxide
incredibly potent
must maintain below a level of 2 ppm
What toxic molecules can iNO form? ANS - peroxynitrite
can damage other biological tissue cells in the body
weaning from iNO ANS - reduce to 50% to 1 ppm then take off
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