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NSER 7110 > Module 3 > Flashcards

Module 3 Flashcards

1
Q

How do you approach someone who is having respiratory issues with the primary assessment?

A

ABC

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2
Q

What are the “Must” in a respiratory assessment?

A

Inspection, auscultation and palpation

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3
Q

What test provides a specific picture of oxygen supply and demand?

A

Arterial blood gas

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4
Q

How does the body compensate for acid base imbalances?

A

Chemical buffering
Respiratory compensation
Renal buffering

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5
Q

What is chemical buffering?

A

Occurs when acids and bases keep the pH within normal limits.
Hydrogen or sodium bicarbonnate molescules are either accepted or released by the cells

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6
Q

What will a change in pH activate?

A

Respiratory compensation

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7
Q

How does respiratory compensation occur?

A

The medulla in the brain is sensitive to pH changes and will alter breathing rate and depth in response to CO2 levels

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8
Q

How long does it take for respiratory compensation to occur?

A

Seconds to minutes

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9
Q

What is renal buffering?

A

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

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10
Q

When is this compensation not as effective?

A

In he elderly due to impaired real function, gas exchange and alveolar membrane size

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11
Q

What are the three main factors which determine oxygen supply?

A
  1. The amount of oxygen that is present in the arterial blood when it leaves the lungs
  2. The capacity of the blood to transport oxygen to the cells
  3. The effectiveness of the pump the circulates the blood throughout the body
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12
Q

What does Sa02 represent?

A

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

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13
Q

What does hemoglobin represent?

A

Indicates the capacity of the blood to transport oxygen to the cells

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14
Q

What does oxygen saturation represent (SpO2)?

A

Measures the saturation of hemoglobin with oxygen

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15
Q

What is oxygen demand dependant on?

A

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

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16
Q

What is SAO2?

A

Arterial oxygen content

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17
Q

What factors is arterial oxygen content dependent on?

A

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)

18
Q

What is ventilation?

A

Defined as he movement of oxygen into and out of the lungs

19
Q

What is ventilation influenced by?

A

The rate and tidal volume of each breath

20
Q

What influences respiratory rate and tidal volume?

A

Work or breathing. respiratory muscle function and lung compliance

21
Q

What is lung compliance?

A

the relationship between the degree to which the tissue will stretch and the force or pressure required to make that stretch occur

22
Q

What is diffusion?

A

Tje exchange of gases across the alveolar-capillary membrane

23
Q

What influences diffusion?

A

By the thickness of the alveolar-capillary membrane and the difference in concentration of gases

24
Q

What is perfusion?

A

When the air distribution (ventilation) and the pulmonary blood flow (perfusion) are well matched
This is known as V/Q matching

25
Q

What can cause a V/Q mismatchinng?

A

Physiological shunts, alveolar dead space, or pulmonary embolus

26
Q

What does hypoxemia stimulate in the respiratory centre?

A

Increases both respiratory rate and total volume in an effort to compensate for lack of oxygen supply

27
Q

How does the neurological system compensate for hypoxemia?

A

A decrease LOC

28
Q

How does the CV system compensate for hypoxemia?

A

Increase heart rate and peripherally vasoconstriction to shunt blood away from non-vital organs back to the core

29
Q

How does the Gl system compensate for hypoxemia?

A

Shunting blood away from non-vital organs

30
Q

What are some signs and symptoms (also consequences) that the GI system is struggling due to hypoxemia?

A

Absent bowel sounds (late indicator)

Ileus formation, bowel rupture and peritonitis

31
Q 
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?

  1. Respiratory Acidosis
  2. Respiratory Alkalosis
  3. Metabolic Acidosis
  4. Metabolic Alkalosis
A

Metabolic alkalosis

32
Q 
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?

  1. Uncompensated
  2. Partially Compensated
  3. Fully Compensated
A

Uncompensated

33
Q 
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?

  1. No Hypoxemia
  2. Mild Hypoxemia
  3. Moderated Hypoxemia
  4. Severe Hypoxemia
A

No hypoxemia

34
Q 
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?

  1. Respiratory Acidosis
  2. Respiratory Alkalosis
  3. Respiratory and Metabolic Acidosis
  4. Respiratory and Metabolic Alkalosis
A

Respiratory and metabolic acidosis

35
Q 
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?

  1. Uncompensated
  2. Partially Compensated
  3. Fully Compensated
A

Uncompensated

36
Q 
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?

  1. No Hypoxemia
  2. Mild Hypoxemia
  3. Moderated Hypoxemia
  4. Severe Hypoxemia
A

Moderate hypoxemia

37
Q

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?

  1. No Hypoxemia
  2. Mild Hypoxemia
  3. Moderated Hypoxemia
  4. Severe Hypoxemia
A

No hypoxemia

38
Q

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.

  1. Uncompensated
  2. Partially Compensated
  3. Fully Compensated
A

Partially compensated

39
Q

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?

  1. Respiratory Acidosis
  2. Respiratory Alkalosis
  3. Metabolic Acidosis
  4. Metabolic Alkalosis
A

Respiratory alkalosis

40
Q

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
A

Mild hypoxemia

41
Q

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.

  1. Uncompensated
  2. Partially Compensated
  3. Fully Compensated
A

Partially compensated

42
Q 
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?

  1. Respiratory Acidosis
  2. Respiratory Alkalosis
  3. Metabolic Acidosis
  4. Metabolic Alkalosis
A

Metabolic acidosis

NSER 7110 (6 decks)

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