Lecture 19: Normal and Abnormal Pulmonary Physiology Flashcards
normal SpO2 and PaO2
SpO2 = 95-100%
PaO2 = 80-100 mmHg
SpO2 of 90% correlates with PaO2 of 60 mmHg (minimum O2 concentration to prevent ischemia)
what is the saturation of peripheral O2 (SpO2)
% of Hgb bound to O2
non-invasive measurement
measures how much O2 is being delivered to tissue
not as exact a measurement
what is partial pressure of O2 (PaO2)
partial pressure of dissolved O2 in arterial blood
requires arterial blood gas draw lab
reflective of the balance of O2 delivery and consumption
most accurate way to determine effectiveness of blood oxygen saturation
normal respiratory rate
12-18 breaths per min at rest (some references say 12-20)
regular rhythm and non-labored effort
tidal volume ~500mL
no audible sounds
Eupnea = normal breathing rate and pattern
normal pulmonary vital signs
SpO2 = 95-100%
PaO2 = 80-100 mmHg
Respiratory Rate = 12-18 bpm
what is B type natriuretic peptide (BNP), normal ranges, and indication
a cardiac biomarker
normal <100 pg/mL
released in response to ventricular stretch or worsening heart failure
normal Hemoglobin (Hgb), lab category, and indication
a CBC value
normal (g/dL):
M = 14-18
F = 12-16
Hgb transports O2
normal blood gas values and indications
pH = 7.35-7.45
PaO2 = 80-100 mmHg
PaCO2 = 35-45 mmHg
HCO3 = 22-26 mEq/L
all portions that control normal blood chemistry for optimal physiological function
normal SpO2 response to exercise
initial transient drop when exercise starts
increase in respiratory rate brings back SpO2 back to stable/normal levels with increasing work load
SpO2 may increase with long duration tasks as steady state is reached
respiratory rate normal response to exercise
gradual increase with increased workload
maintains a steady state with minimal change at steady state exercise
rapid rise after/if anaerobic threshold (VT2) is reached
normal lung volume response to exercise
increases linearly with work
tidal volume increases to meet the demands of exercise and can approach vital capacity volumes
physiological progression that happens with respiration during exercise
mm cell respiration increases; more O2 is used; increase in CO2
brain detects increase in CO2; CNS signals lungs to increase RR
increased RR and volume of each breath; increase in gas exchange occurs
CNS signals heart to increase HR so more blood is pumped to the lungs for gas exchange
increased O2 gets sent to the mm to balance supply and demand
increased CO2 removed from blood and blown off via increased RR
vital signs that are concerning with a pulmonary patient
SpO2 <90% at rest or acute change in O2 demand/device
RR <10 or >30 at rest or unable to maintain conversation
HR <50 or >120 at rest or an uncontrolled/new arrhythmia
BP >180/90, <90/60, or MAP <60
what could potentially cause hypoxemia/hypoxia in a pt
heart/lung disease
hypoventilation
infection
anemia
carbon monoxide poisoning
PE
V/Q mismatch
sleep apnea
airway obstruction
high altitude
what is hypoxemia vs hypoxia
hypoxemia = low blood O2 levels measured by SpO2 or PaO2 (blood)
hypoxia = under oxygenation of tissues that impair cellular metabolism (cellular)