Module 3 Flashcards
How do you approach someone who is having respiratory issues with the primary assessment?
ABC
What are the “Must” in a respiratory assessment?
Inspection, auscultation and palpation
What test provides a specific picture of oxygen supply and demand?
Arterial blood gas
How does the body compensate for acid base imbalances?
Chemical buffering
Respiratory compensation
Renal buffering
What is chemical buffering?
Occurs when acids and bases keep the pH within normal limits.
Hydrogen or sodium bicarbonnate molescules are either accepted or released by the cells
What will a change in pH activate?
Respiratory compensation
How does respiratory compensation occur?
The medulla in the brain is sensitive to pH changes and will alter breathing rate and depth in response to CO2 levels
How long does it take for respiratory compensation to occur?
Seconds to minutes
What is renal buffering?
Kindeys will eliminate either acids or bases as needed, creating a more acidic urine or alkaline urine
Kidneys also control bicarb (HCO3) in the extracellular fluid by either reabsorbing or excreting H+ ions
When is this compensation not as effective?
In he elderly due to impaired real function, gas exchange and alveolar membrane size
What are the three main factors which determine oxygen supply?
- The amount of oxygen that is present in the arterial blood when it leaves the lungs
- The capacity of the blood to transport oxygen to the cells
- The effectiveness of the pump the circulates the blood throughout the body
What does Sa02 represent?
Arterial oxygen content (calculated in arterial blood gases) reflects the amount of oxygen that is present in the arterial blood when it leaves the lungs
What does hemoglobin represent?
Indicates the capacity of the blood to transport oxygen to the cells
What does oxygen saturation represent (SpO2)?
Measures the saturation of hemoglobin with oxygen
What is oxygen demand dependant on?
Metabolic needs
Any factor that increases or decreases the amount of oxygen the cells consume will influence oxygen demand
Ex: An increase in temp will increase oxygen demand
What is SAO2?
Arterial oxygen content
What factors is arterial oxygen content dependent on?
The concentration of oxygen in the air we breath
the ability to get air into and out of the lungs (ventilation)
The effectiveness of the gas exchange at the alveolar-capillary membrane (diffusion)
The ability of he blood to exchange oxygen in the lungs (perfusion)
What is ventilation?
Defined as he movement of oxygen into and out of the lungs
What is ventilation influenced by?
The rate and tidal volume of each breath
What influences respiratory rate and tidal volume?
Work or breathing. respiratory muscle function and lung compliance
What is lung compliance?
the relationship between the degree to which the tissue will stretch and the force or pressure required to make that stretch occur
What is diffusion?
Tje exchange of gases across the alveolar-capillary membrane
What influences diffusion?
By the thickness of the alveolar-capillary membrane and the difference in concentration of gases
What is perfusion?
When the air distribution (ventilation) and the pulmonary blood flow (perfusion) are well matched
This is known as V/Q matching
What can cause a V/Q mismatchinng?
Physiological shunts, alveolar dead space, or pulmonary embolus
What does hypoxemia stimulate in the respiratory centre?
Increases both respiratory rate and total volume in an effort to compensate for lack of oxygen supply
How does the neurological system compensate for hypoxemia?
A decrease LOC
How does the CV system compensate for hypoxemia?
Increase heart rate and peripherally vasoconstriction to shunt blood away from non-vital organs back to the core
How does the Gl system compensate for hypoxemia?
Shunting blood away from non-vital organs
What are some signs and symptoms (also consequences) that the GI system is struggling due to hypoxemia?
Absent bowel sounds (late indicator)
Ileus formation, bowel rupture and peritonitis
Jack is a 55 year-old with GERD. He takes about 15 TUMS antacid tablets a day. An ABG is obtained to assess his acid/base balance: pH 7.46 CO2 42 pO2 86 HCO3 29 SaO2 97%
What is his state?
- Respiratory Acidosis
- Respiratory Alkalosis
- Metabolic Acidosis
- Metabolic Alkalosis
Metabolic alkalosis
Jack is a 55 year-old with GERD. He takes about 15 TUMS antacid tablets a day. An ABG is obtained to assess his acid/base balance: pH 7.46 CO2 42 pO2 86 HCO3 29 SaO2 97%
What type of compensation is this?
- Uncompensated
- Partially Compensated
- Fully Compensated
Uncompensated
Jack is a 55 year-old with GERD. He takes about 15 TUMS antacid tablets a day. An ABG is obtained to assess his acid/base balance: pH 7.46 CO2 42 pO2 86 HCO3 29 SaO2 97%
What type of hypoxia is this?
- No Hypoxemia
- Mild Hypoxemia
- Moderated Hypoxemia
- Severe Hypoxemia
No hypoxemia
Interpret the following blood gas obtained on a patient post arrest: pH 6.89 CO2 70 pO2 42 HCO3 13 SaO2 50%
What is his state?
- Respiratory Acidosis
- Respiratory Alkalosis
- Respiratory and Metabolic Acidosis
- Respiratory and Metabolic Alkalosis
Respiratory and metabolic acidosis
Interpret the following blood gas obtained on a patient post arrest: pH 6.89 CO2 70 pO2 42 HCO3 13 SaO2 50%
What type of compensation is this?
- Uncompensated
- Partially Compensated
- Fully Compensated
Uncompensated
Interpret the following blood gas obtained on a patient post arrest: pH 6.89 CO2 70 pO2 42 HCO3 13 SaO2 50%
What type of hypoxia is this?
- No Hypoxemia
- Mild Hypoxemia
- Moderated Hypoxemia
- Severe Hypoxemia
Moderate hypoxemia
Louis is a 18 year-old comatose, quadriplegic patient who has the following ABG done as part of a medical workup:
pH 7.48 CO2 22 pO2 96 HCO3 16 SaO2 98%
What type of hypoxia is this?
- No Hypoxemia
- Mild Hypoxemia
- Moderated Hypoxemia
- Severe Hypoxemia
No hypoxemia
Louis is a 18 year-old comatose, quadriplegic patient who has the following ABG done as part of a medical workup:
pH 7.48 CO2 22 pO2 96 HCO3 16 SaO2 98%
Select the appropriate response.
- Uncompensated
- Partially Compensated
- Fully Compensated
Partially compensated
Louis is a 18 year-old comatose, quadriplegic patient who has the following ABG done as part of a medical workup:
pH 7.48 CO2 22 pO2 96 HCO3 16 SaO2 98%
What is his state?
- Respiratory Acidosis
- Respiratory Alkalosis
- Metabolic Acidosis
- Metabolic Alkalosis
Respiratory alkalosis
Bruce is an 80 year-old man transferred from a nursing home with fever, chills, dysuria and increasing confusion.
pH 7.02 CO2 30 pO2 77 HCO3 14 SaO2 89%
Select the appropriate response. What type of hypoxia is this? 1. No Hypoxemia 2. Mild Hypoxemia 3. Moderated Hypoxemia 4. Severe Hypoxemia
Mild hypoxemia
Bruce is an 80 year-old man transferred from a nursing home with fever, chills, dysuria and increasing confusion.
pH 7.02 CO2 30 pO2 77 HCO3 14 SaO2 89%
Select the appropriate response.
- Uncompensated
- Partially Compensated
- Fully Compensated
Partially compensated
Bruce is an 80 year-old man transferred from a nursing home with fever, chills, dysuria and increasing confusion. Interpret his blood gas: pH 7.02 CO2 30 pO2 77 HCO3 14 SaO2 89%
What is his state?
- Respiratory Acidosis
- Respiratory Alkalosis
- Metabolic Acidosis
- Metabolic Alkalosis
Metabolic acidosis
