Chapter 20 Respiratory Diagnostics Flashcards
What do ABG studies measure? What makes them important?
ABGs study the ability of the lungs to provide adequate oxygen and remove carbon dioxide. Not only does this resemble how well the patient is ventilating but it also shows how well the kidneys can maintain pH by excreting bicarb ions.
How are ABGs obtained?
Through ARTERIAL puncture mostly through radial, brachial, femoral arteries, or an indwelling arterial catheter.
What are the normal values of an ABG result?
pH - 7.35-7.45 CO2 - 35-45 Bicarb - 22-26
What is a bronchoscopy? What is it used for?
A direct inspection of the larynx, trachea, and bronchi using a rigid or flexible fiberoptic bronchoscope. These are used diagnostically to visualize tissue and assess nature, location, and extent of pathological processes.. collect secretions or tissue for analysis, determine a tumors ability to be resected, and to diagnose sources of hemoptysis. These are also used therapeutically to remove foreign bodies or secretions from the tracheabronchial tree, control bleeding, treat postoperative atelectasis, destroy and excise lesions, provide brachytherapy (endotrachial radiation therapy), and to place stents to relieve obstructions of airway from tumors or benign conditions from lung transplantation
What is a thoracentesis? What is it used for?
Thoracentesis is used to aspirate fluid and air from the pleural cavity by inserting a hollow needle into the pleural cavity.
These can be used to relieve pressure from fluid and air in the pleural space, or for fluid analysis, pleural biopsy, instillation of medication into the pleural space. The studies conducted from the aspirated fluid consist of culture and sensitivity (Gram staining and acid-fast), differential cell count, cytology, pH, total protein, lactic dehydrogenase, glucose, amylase, triglycerides, and cancer markers.
What is the definition of oxygen therapy?
What is the goal and purpose of oxygen therapy?
The administration of oxygen at a concentration great than that of the atmosphere (21%).
The goal of adequate oxygen therapy is to enhance the transport of oxygen in the blood while decreasing the work of breathing as well as the stress on the myocardium.
What things can affect oxygen transport to tissues?
CO
Arterial oxygen content
hemoglobin
metabolic needs
What is the definition and some signs and symptoms of hypoxemia?
Changes in mental status (impaired judgement, agitation, disorientation, confusion, lethargy, coma), dyspnea, Increased BP, changes in HR, dysrhythmias, central cyanosis (late sign), diaphoresis, cool extremities.
What are signs of rapidly developing hypoxia?
How do these symptoms differ from long-standing hypoxia (COPD, heart failure)?
CNS symptoms: may seem like alcohol intoxication (lack of coordination and impaired judgement)
fatigue, drowsiness, apathy, inattentiveness, delayed reaction time
How woould you assess a patient that is receiving oxygen therapy?
Asess respiratory system, skin (especially pressure points), oxygen tubing and flow rate, look for signs of hypoxia, look at pulse oximetry and ABG results
What is the suggested flow rate and percentage setting for a nasal cannula?
1-6L
23-42%
What are some advantages and disadvantages of a nasal cannula?
Pros: Lightweight, comfortable, inexpensive, continuous use with meals and activity
Cons: Nasal mucosa drying (usually when using 4-6L), variable FiO2
