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RT (PFT) II Semestre > Chapter # 6 (Blood Gases) > Flashcards

Chapter # 6 (Blood Gases) Flashcards

1
Q

What are the reason to obtain Blood Gases?

A
  • Assessment of Ventilaroty Status
  • Assessment of acid-base Balance
  • Assessment of Arterial Oxygenation
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2
Q

What are the system involved in mantain Acid base Balance?

A
  • Lung Function
  • Renal Function
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3
Q

Acidemia is considered when?

A

.When PH is dropped bellow < 7.35

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4
Q

Alkalimia is considered when?

A

PH is above > 7.45

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5
Q

The PCO2 pressure will be greater in Venous or Arterial Blood?

A

In Venous (46 mm Hg) while in Arterial Blood will be 40 mm Hg after exchange in the lung.

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6
Q

What will happen to a patien’s PCO2 and PH when is not breathing enough.

A

PCO2 will go ↑ (>45) and PH will go ↓(<7.35)

( Respiratory Acidosis)

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7
Q

If a patient started to breath too much, PaCO2 and PH will move in what direction?

A

PaCO2 will move↓(<35 mmHg) and PH will move ↑(>7.45)

(Respiratory Alkalosis)

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8
Q

When a patient exhale more than normal (↑ ventilation >20 Breaths/min), PH will be more Alkalotic or Acidotic?

A

Alkalotic

By breathing more patient will exhale more CO2 making it more alklotic

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9
Q

Normal Bocabonate (HCO3) value is?

A

24 mRq/L

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10
Q

When HCO3 is ↓, this is?

A

Metabolic Acidosis (<22 mEq/L)

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11
Q

When HCO3 is ↑, this is?

A

Metabolic Alkalosis (>26 mEq/L)

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12
Q

↑PCO2 and ↓ HCO3 this is?

A

Combined Respiratory/Metablolic Acidosis.

  • ↑PCO2 (>45) = Acidosis
  • ↓HCO3 (<22 mEq/L) Acidosis
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13
Q

↓PCO2 and ↑HCO3 this is?

A

Combined Respiratory/Metabolic Alkalosis

  • ↓ PaCO2 < 35 = Alkalosis
  • ↑ HCO3 > 26 mEq/L = Alkalosis
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14
Q

Compensation is?

A

Is when the system that is not primary involve jump in to bring the PH back to normal

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15
Q

True or False

Tissue Hypoxemia exist when cellular oxygen tensions are inadequate to meet cellular oxygen demands.

A

TRUE

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16
Q

What value has become the primary tool for clinical evaluation of the Arterial Oxygenation Status?

A

PaO2

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17
Q

when we said Hypoxemia is present?

A

When Arterial oxygen Tension is bellow normal range

  • Normal 97 mm Hg
  • Acceptable range ≥ 80 mm Hg
  • Hypoxemia < 80 mm Hg
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18
Q
  • PH 7.26
  • PCO2 56
  • HCO3- 24
  • PO2 50

Interpret this blood Gas?

A

PCO2 is Hight >45 (Acid) , Parient is breathing Slow ( this should procuced acidotic PH)

PH is Low < 7.35, this is acid

HCO3 is normal (22 - 26 mEq/L)

PO2 50 = Hypoxemia

Here we have:

Acute Ventilatory failure with Hypoxemia

or

Acute Respiratory Acidosis with Hypoxemia

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19
Q

Regarding to the previous exersice why it is an acute and not a chronic problem?

A

It is Acute becauce HCO3 have not move it is kept in the normal range, meaning that this problem is just happening

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20
Q

Interpret this exercise

  • PH 7.56
  • PCO2 29
  • HCO3- 24
  • PO2 90
A

Acute Alveolar hyperventilation without Hypoxemia

or

Acute Respiratory Alkalosis without Hypoxemia

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21
Q

What is pulse Oxymetry?

A

Is the noninvasive stimation of SaO2

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22
Q

Where Pulse Oximetry may be use?

A
  • O2 Therapy
  • Ventilation managment
  • Diagnosis procedures
  • Sleep studies
  • Stress Testing
  • Pulmonary rehabilitation
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23
Q

In the pulse Oximetry, It’s true that the amount of light absorbed is proprtional to the concentration of Hb in the blood vessels?

A

Yes it’s true, By mesuring the light detector, the pulse Oximetry knows how much light has been absorbed. The more hemoglobin in the finger, the more light will be absorbed

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24
Q

The pulse Oximetry uses how many lights to detect the amount of Oxyhemoglobin (O2Hb) and Deoxyhemoglobin (rHb)

A

It uses two lihgts:

  • Red
  • Infrared
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25
Q

On Pulse Oximetry, a lot of Hb will absorbed more or less light?

A

More light wil be absorbed

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26
Q

On the pulse Oximetry wich light will determine the amount of Hb in the blood, the red or the infrared light?

A

The Red Light

27
Q

What subtances can interfare pulse Oximetry reading?

A
  • COHb ( carbon monoxide hemoglobing)
  • MetHb
  • Intravascular dyes
  • Nail polish
28
Q

What are the interfaring Factors of Pulse oximetry?

A
  • Motion, Shivering
  • Bright ambient
  • Hypotension
  • Hypothermia
  • Vasoconstriction drugs
  • Dark Skin pigmentation
29
Q

Pulse Oximetry Criteria of acceptability

A
  • Correlation with measured SaO2
  • SpO2 should be within 2% from 85 - 100%
  • Elevated levels of COHb (>3%) or MetHb (>5%) may invalidate SpO2
  • Adecuate perfusion of the sensor site as seen in the plethysmographic, tracing an correlation with the patient’s heart rate
  • Know interfering subtances
  • Reading should be consistent with the patient’s clinical history.
30
Q

What is Oxygen Saturation?

A

Is the ratio of either Oxygenated Hb to the total available Hb

31
Q

TRUE or FALSE

Co-Oximeters actually measures SaO2 using Spectrophotometry

A

TRUE

SaO2 = O2Hb x 100

(O2Hb + rHb + COHb + MetHb)

32
Q

SaO2 normal value is?

33
Q

SvO2 Normal Value is?

34
Q

COHb Normal Value is?

A

0.5 % - 2% of total Hb

35
Q

Normal Total Hb in Males is?

A

14 - 16 gm%

36
Q

Normal Tolal Hb in Female is?

A

13 - 15 gm%

37
Q

Capnography is:

A

Is the continous noninvasive monitoring or expired CO2 and analysis of the single breath CO2 wave form

38
Q

Normal PaCO2 values?

A

35 - 45 mm Hg

39
Q

Normal ETCO2 Values?

A

30 - 43 mmHg

40
Q

Arterial - End Tidal CO2 Gradient, In healthy lung the normal PaCO2 to PETCO2 gradient is :

A

2 - 5 mmHg

41
Q

In disease Lung, The Arterial - End Gradient will be:

A

Increased due to Ventilation/Perfusion mistmach

42
Q

Normal VAis:

A

4 liters of air per minute is the average

(we know that the normal Alveolar ventilation is 4 - 5 L/mim)

43
Q

Normal Q (perfusion) value is:

A

5 Liters of Blood per minute ( this is the amount of blood that is usually perfussed trhouht capillaries
)

so norml V/Q is 4/5 or 0.8

44
Q

What happen when V/Q is < 0.8?

A

There is a V/Q mistmash caused by poor ventilation

45
Q

V/Q greater than 0.8 means?

A

Too much Ventilation

46
Q

Shunt Alvioli is ?

A

Alvioli is perfused but not ventilated

47
Q

This is ?

A

Normal Ventilation and perfusion mismatsh

48
Q

This is ?

A

Dead Space, Alvioli is ventilated but not persused ( usually caused by pulmonary embolism)

49
Q

If shunt is present, ETCO2, PaCO2 gradient will get?

A

Larger( 4 - 10 mmHg)

50
Q

What can cause pulmonary shunt?

A

Everything that blocked ventilation:

  • Muccus Plugging
  • ET tube on the right main bronchus
  • Atelectasis
  • Pneumonia
  • Pulmonary Edema
51
Q

What Diseases may cause Dead Space Ventilation?

A
  • Pulmonary embolism
  • Hypovolemia
  • Cardiac arrest
  • Shock

(Anithing that causes a significant drop in pulmonary blood flow)

52
Q

This is?

A

Normal Capnogram

53
Q

This is?

A

Beginning of expiration, anatomical dead space with not measurable CO2

54
Q

Normal Cpnogram Phase II is?

A

Mixed CO2, rapid rise in CO2 concentration

55
Q

Normal Capnogram Phase III is?

A

Alveolar Plateau, all exhaled CO2 gas took part in gas exchage

56
Q

Normal Capnogram Phase IV is?

A

Here inspiration starts, CO2 drops off rapidly

57
Q

This is what type of Capnogram?

A

Normal Capnogram, Stable Trend

58
Q

This is whar type of Capnogram?

A

Hyperventilation, decrease in ETCO2. Possible caused by?

  • Increased in Respiratory Rate
  • Increased in Tidal Volume
  • Decreased in Metabolic Rate
  • Fall in Body Temperature
59
Q

This is?

A

Hypoventilation, Increased ETCO, possible caused by?

  • Deacreased in Respiratory Rate
  • Decreased in Tidal Volume
  • Increased in Metabolic Rate
  • Rapid Rise in Body Temperature
60
Q

And this will be what type of Capnogram?

A

Missed Intubation, when ET tube is in esophagus, little or not CO ispresnt.

61
Q

What is Septicemia

A

Infection in the blood, this causes CO2 to be increased

62
Q

What create a large gradient

A

Dead Space (PaCO2/ETCO 2 - 5 is normal)

RT (PFT) II Semestre (10 decks)

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