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Flight Paramedic Certification > Acid Base Balance and Oxygen Management > Flashcards

Acid Base Balance and Oxygen Management Flashcards

1
Q

FiO2

A

Fraction of inspired oxygen

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2
Q

PaO2

A

Partial arterial pressure of oxygen

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3
Q

PAO2

A

Partial pressure of alveolar oxygen

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4
Q

PvO2

A

Partial pressure of venous oxygen

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5
Q

Sao2

A

Arterial saturation of oxygen

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6
Q

Body’s preferred source of energy

A

Glucose

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7
Q

Aerobic Cellular metabolism

A

Glycolysis (2ATP) -> Pyruvic acid-> Acetyl coA -> Krebs cycle (2ATP) -> electron transport chain (34ATP)= 38 total ATP

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8
Q

What are the primary biproducts of Aerobic metabolism?

A

H2O and CO2

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9
Q

Anaerobic Cellular metabolism

A

Glycolysis (2ATP) -> Pyruvic acid -> Lactic acid

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10
Q

What is the primary biproduct of Anaerobic metabolism?

A

Lactic acid

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11
Q

What is shock?

A

Inadequate tissue oxygenation

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12
Q

Lactate levels

A

Normal = 0.5-1.5

>2.0 in ill patients signals lactic acidosis

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13
Q

Left shift of Oxyhemoglobin dissociation curve

A

Less hydrogen, holds on to oxygen instead.

Alkalosis

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14
Q

Causes of Left shift of Oxyhemoglobin dissociation curve

A

Low temp
Low 2-3DPG
Carbon Monoxide

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15
Q

Right shift of Oxyhemoglobin dissociation curve

A

Hydrogen rich environment.
Releases O2 quickly.
Acidosis

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16
Q

Causes of Right shift of Oxyhemoglobin dissociation curve

A

Raised acidosis
Raised temp
Raised 2-3 DPG
Reduced oxygenation

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17
Q

Carbonic acid - bicarbonate buffer system formula

A

Co2 + H20 = H2co3 (carbonic acid) = H+ / HCO3-

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18
Q

Fastest buffering system

A

Carbonic acid - bicarbonate buffering system work second to second in blood, lungs and kidneys but is easy to overwhelm.

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19
Q

Intermediate buffering system

A

Lungs adjust H2CO3 by blowing off or holding onto CO2.

Works Minute to Minute

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20
Q

Slow buffering system

A

Kidneys can reabsorb, create, or excrete HCO3- or H+.

Takes hours to days.

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21
Q

PaCO2 change of __ mmHg causes a Ph change of __ in opposite direction.

A

10 mmHg

0.08

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22
Q

Primary intracellular cation

A

Potassium

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23
Q

Primary extracellular cation

A

Sodium

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24
Q

For every change in Ph of __ , there is a change in Potassium of __ MEq/L in the opposite direction.

A
  1. 1

0. 6

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25
Q

For every change in PaCO2 of __ mmHg, there is a change in Potassium of __ MEq/L in the opposite direction.

A

10

0.5

26
Q

What causes a false high Potassium level?

A

Acidosis

27
Q

What causes a false low Potassium level?

A

Alkalosis

28
Q

Treatment of Hyperkalemia >5.5

A

Correct acid-base balance first
Calcium chloride (raises action potential)
NaHCO3 (Raises Ph, Moves K+ intracellular)
D50/Insulin
B2 agonist (albuterol)
Lasix
Kayexalate

29
Q

Treatment Hypokalemia <3.5

A

Correct acid-base balance
Do not exceed 0.5-1.0 MEq/kg/hr
Normal is 10-20 MEq/hr

30
Q

What is a normal Arterial Ph?

A

7.35-7.45

31
Q

What is a normal PaCO2?

A

35-45

32
Q

What is a normal Arterial HCO3-?

A

22-26

33
Q

What is a normal PaO2?

A

80-100

34
Q

What is a normal SaO2?

A

> 95%

35
Q

What is a normal BE (base excess)?

A

-2 to 2

36
Q

ABG interpretation
Ph 7.19
PCo2 66
HCO3- 24

A

Uncompensated respiratory acidosis

37
Q

ABG interpretation
Ph 7.27
PCo2 37
HCO3- 14

A

Uncompensated metabolic acidosis

38
Q

ABG interpretation
Ph 7.58
PCo2 14
HCO3- 22

A

Uncompensated respiratory alkalosis

39
Q

ABG interpretation
Ph 7.48
PCo2 41
HCO3- 30

A

Uncompensated metabolic alkalosis

40
Q

ABG interpretation
Ph 7.09
PCo2 60
HCO3- 14

A

Mixed disturbance (Both are causing issues)

41
Q

ABG interpretation
Ph 7.31
PCo2 68
HCO3- 34

A

Partially compensated respiratory acidosis

42
Q

ABG interpretation
Ph 7.17
PCo2 31
HCO3- 04

A

Partially compensated metabolic acidosis

43
Q

ABG interpretation
Ph 7.51
PCo2 29
HCO3- 37

A

Mixed disturbance

44
Q

PaO2 should equal __ times Fio2

A

5

45
Q

Formula for bicarb replacement

A

Kg/4 x Base deficit = MEq of bicarb needed

46
Q

For every change in HCO3- of __ MEq, the Ph changes __ in the same direction.

A

10

0.15

47
Q

Define Respiratory Acidosis

A

Failure to remove CO2 from plasma / lungs.

Ph <7.40, CO2> 45

48
Q

Fast causes of Respiratory Acidosis

A

Failure to get CO2 to the lungs (decreased Cardiac Output).

Failure to get CO2 out of the lungs (decreased Minute Volume).

49
Q

Slow causes of Respiratory Acidosis

A

Bronchospasm
COPD
V/Q mismatch (P.E., ARDS, Pneumonia)
Pulmonary Edema

50
Q

Treatment of Respiratory Acidosis

A

Remove CO2 by increasing alveolar minute volume

51
Q

Define Respiratory Alkalosis

A

Alveolar hyperventilation causing removal of too much CO2.
Ph >7.40
CO2 <35

52
Q

Causes of hyperventilation

A

Tissue hypoxia secondary to poor supply
Tissue hypoxia secondary to excessive demand
Mechanical hyperventilation (most common)
Anxiety

53
Q

Treatment of Respiratory Alkalosis

A

Control anxiety

Decrease alveolar minute volume (decrease rate, then volume)

54
Q

Define Metabolic Acidosis

A

Ph <7.40
HCO3- <22
Anion Gap >20

55
Q

Normal Anion Gap

A

8-16 (w/o K+ factored)

10-20 (with K+ factored)

56
Q

Causes of Metabolic Acidosis

A 
#1 Lactic Acidosis
#2 DKA
#3 Renal failure
#4 Toxins
57
Q

Primary toxin causing metabolic acidosis

A

Alcohols / Methanol / Ethylene Glycol

58
Q

MUDPILES

A 
Causes of Metabolic Acidosis
Methanol (toxin)
Uremia (renal failure)
DKA
Paraldehyde (toxin)
Iron (toxin)
Lactate
Ethylene glycol (toxin)
Salicylate (toxin)
59
Q

Treatment of Metabolic Acidosis

A

Treat the cause!
Lactic? Good oxygenation, improve cardiac output
DKA? Control sugar, correct acidosis
Renal failure? Identify treatable conditions
Toxins? stop intake, look for antidote, supportive care

60
Q

Metabolic Alkalosis

A

Too much HCO3 or too little H+ (hydrogen = acid)
Ph >7.40
HCO3- >26
Worst of the Worst!

61
Q

Causes of Metabolic Alkalosis

A

Think Electrolyte disorder! (#1 cause)
GI loss of H+ (OG/NG suctioning, N/V)
GI loss of electrolytes (diarrhea)
Renal loss of potassium and hydrogen

62
Q

Treatment of Metabolic Alkalosis

A

Identify and correct electrolyte abnormalities

Focus on Potassium, Magnesium, and Calcium

Flight Paramedic Certification (15 decks)

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