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RESP 101, Assessment and Caring for a Respiratory Patient > Need to Know Stats > Flashcards

Need to Know Stats Flashcards

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1
Q

Vital Signs (Per Egan) Adult
1. Heart Rate (HR) Pulse Rate
2. Respiratory Rate (RR)
3. Blood Pressure
4. Pulse Ox

A
  1. Heart Rate: 60-100 Beats/Minute
  2. Respiratory Rate: 12-18 Breaths/Minute
  3. Blood Pressure: 90-140 systolic/60-90 diastolic (MMHG)=Millimeters of Mercury
  4. Pulse Ox: >92% (per most hospital policies)
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2
Q

Vital Signs (Per Wilkins) Adult
1. Heart Rate (HR) Pulse Rate
2. Respiratory Rate (RR)
3. Blood Pressure
4. Pulse Ox

A
  1. Heart Rate: 60-100 Beats/Minute
  2. Respiratory Rate: 12-20 Breaths/Minute
  3. Blood Pressure: 120 systolic/80 diastolic (MMHG)=Millimeters of Mercury (Median)
  4. Pulse Ox: >92% (per most hospital policies)
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3
Q

Volume-Pressure (V-P) Conversion Factors

A
  1. E Cylinder: 622.0 L / 2200 psi = 0.28
  2. H Cylinder: 6900.0 L / 2200 psi = 3.14
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4
Q

Equation to Determine: How much time there is of O2 in a Cylinder. Using Tank Pressure * V-P Factor / Liter Flow. Example: 2000 psi, E cylinder, 3 L Flow

A

2000 psi * .28 Factor= 560
560 / 3 L Flow = 186.66
186.66 / 60 min = 3.11
.11 min * 60 sec = 6.6
Answer is 3 hours and 6 minutes

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5
Q

Room Air Oxygen %
Cylinder Air Oxygen % per Liter for Nasal Canula (NC)

A
  1. Room Air has 2% Oxygen
  2. Cylinder Air for 1L has 24% Oxygen For NC
    *For every liter of air in Cylinder the Oxygen % Increases by 4%
  3. Cylinder Air for 2L has 28% Oxygen NC
  4. Cylinder Air for 3L has 32% Oxygen NC
  5. Cylinder Air for 4L has 36% Oxygen NC
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6
Q

Reference Intervals for CBC
Red Blood Cell Count

A

Wilkins: x 10^6/uL (x10^12/L)
Males: 4.20 - 6.00
Females: 3.80 - 5.20

Eagan: x 10^6/mcL
Males: 4.4 - 5.9
Females: 3.8 - 5.2

Red Blood Cells carry O2. If patient has low RBC count it could mean he/she is anemic

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7
Q

Reference Intervals for CBC
White Blood Cell Count

A

Wilkins: x 10^3/uL (x10^9/L)
Both: 4.0 - 11.0

White Blood Cells fight off infection. An increase in WBC count could mean patient is fighting an infection

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8
Q

Reference Intervals for CBC
Hemoglobin (Hb)

A

Wilkins: g/dL (g/L)
Males: 13.5 - 18.0 (135-180)
Females: 12.0 - 15.0 (120-150)

Egan: g/dL
Males: 13.3 - 17.7
Females: 11.7 - 15.7

Main component of RBC. Protein that carries oxygen to the tissues. Helps maintain acid-base balance by acting as a buffer and by carrying CO2 from tissues to the lungs

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9
Q

Reference Intervals for CBC
Hematocrit (Hct)

A

Wilkins: % (L/L)
Males: 40 - 54 (0.40-0.54)
Females: 35 - 49 (0.35-0.49)

Egan:
Males: 40% - 52%
Females: 35% - 47%
WBC count: 3.9 - 11.7 x 10^3/mcL

Hct is the ratio of RBC volume to whole blood. A low Hct occurs with anemia and a high Hct with polycythemia. Hct also reflects patient’s hydration status. High Hct is a sign of dehydration

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10
Q

Reference Intervals for CBC
Platelet Count

A

Wilkins: x 10^3/uL (x10^9/L)
Both: 150 - 450

Egan: x 10^3/mcL
Both: 150 - 400

AKA thrombocytes. Abnormally low platelet count is called thrombocytopenia. The lower the platelet count, the more likely the patient will have problems with bleeding.

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11
Q

Reference Intervals for CBC
“Rule of Five” for RBC, Hemoglobin, Hematocrit

A

Both Sexes
RBC: 5
Hemoglobin: 5 x 3 = 15 (Hb)
Hematocrit: 15 x 3 = 45 (HcT)

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12
Q

Reference Intervals for WBC
Segmented Neutrophils

A

Wilkins:
Relative: 50% -70%
Absolute: 1.5 - 7.5 x 10^3/uL (x10^9/L)

Egan:
Relative: 40% - 75%
Absolute: 1.8 - 6.8 x 10^9/L

Increased with bacterial infection and trauma; reduced with bone marrow diseases (critical value <1.0). Produced in the bone marrow

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13
Q

Reference Intervals for WBC
Eosinophils

A

Wilkins:
Relative: 1% - 3%
Absolute: 0 - 0.4 x 10^3/uL (x10^9/L)

Egan:
Relative: 0% - 6%
Absolute: 0 - 0.1 x 10^6/L

Increased with allergic reactions and parasitic infections

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14
Q

Reference Intervals for WBC
Basophils

A

Wilkins:
Relative: 0% - 1%
Absolute: 0 - 0.1 x 10^3/uL (x10^9/L)

Egan:
Relative: 0% - 1%
Absolute: 0 - 0.1 x 10^6/L

Increased with allergic reactions

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15
Q

Reference Intervals for WBC
Lymphocytes

A

Wilkins:
Relative: 20% - 45%
Absolute: 1.0 - 4.0 x 10^3/uL (x10^9/L)

Egan:
Relative: 20% - 45%
Absolute: 1.0 - 3.4 x 10^9/L

Increased with viral and other infections; reduced with immunodeficiency problems. Useful against viral, fungal, and tuberculosis infections. T cells involved in cell mediated immunity. B cells develop antibodies. Natural Killer (NK) cells 3rd type of lymphocytes.

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16
Q

Reference Intervals for WBC
Monocytes

A

Wilkins:
Relative: 2% - 11%
Absolute: 0.1 - 1.3 x 10^3/uL (x10^9/L)

Egan:
Relative: 2% - 10%
Absolute: 0.2 - 0.8 x 10^6/L

Increased with invasion of foreign material. Largest of the WBCs. Plays key role in clearing the lung of inhaled dust through phagocytosis by macrophage.

17
Q

Reference Intervals for BMP (Basic Metabolic Panel)
Sodium
Potassium
Chloride
Total CO2
Glucose
BUN
Creatinine

A

Wilkins/Egan
1. Sodium (NA+): 135-145 mmol/L / 136-145 mmol/L
2. Potassium (K+): 3.5-5.0 mmol/L / 3.5-5.0 mmol/L
3. Chloride (CL-): 98-107 mmol/L / 98-109 mmol/L
4. Total CO2: 22-30 mmol/L / 22-29 mmol/L
5. Glucose (fasting): 70-99 mg/dL / 70-139 mg/dL
6. BUN: 7-20 mg/dL / 8-23 mg/dL
7. Creatinine: 0.7-1.3 mg/dL / 0.7-1.3 mg/dL

18
Q

Reference Intervals for Renal Panel
BUN
Creatinine
GFR
Urinalysis

A

Wilkins/Egan
1. BUN: 7-20 mg/dL / 8-23 mg/dL
2. Creatinine: 0.7-1.3 mg/dL / 0.7-1.3 mg/dL
3. GFR: 90-120 mL/min/1.73 m2
4. Urinalysis: Multiple tests

19
Q

Reference Intervals for Hepatic Panel
Albumin
Total Protein
ALP
ALT
AST
Bilirubin

A

Wilkins/Egan
1. Albumin: 3.5-5.0 g/dL / 3.4-4.8 g/dL
2. Total Protein: 6.3-8.0 g/dL / 6.4-8.3 g/dL
3. ALP: 38-126 U/L
4. ALT: 10-40 U/L / 10-40 U/L male 7-35 U/L female
5. AST: 5-30 U/L / 10-41 U/L
6. Bilirubin (total): 0.3-1.9 mg/dL / 0.1-1.2 mg/dL

20
Q

Reference Intervals for Lipid Profile
Total Cholesterol
HDL-C
LDL-C
Triglycerides

A
  1. Total Cholesterol: <200 mg/dL
  2. HDL-C: >39 mg/dL
  3. LDL-C: <100 mg/dL
  4. Triglycerides: 30-149 mg/dL
21
Q

Reference Intervals for Cardiac Biomarkers
Total CK
CK-MB
cTnl
Myoglobin
BNP

A
  1. Total CK: 50-200 U/L
  2. CK-MB: <5% total CK
  3. cTnl: <0.01 ng/ML
  4. Myoglobin: 19-92 ug/L
  5. BNP: <20 pg/L
22
Q

Oxygen Devices: Nasal Cannula Normal
FiO2 Range
Flow Rate

A

FiO2 = 24% - 44% Variable stability
Flow = 1- 6 L/min Adult

2 - 4 L/min with 28% O2 is what is norm for Nasal Cannula at the hospital setting

If flow rate is greater than 4 L/min or Patient complains of dryness, you will utilize a humidifier.

23
Q

Oxygen Devices: Simple Mask
FiO2 Range
Flow Rate

A

FiO2 = 35% - 50% Variable stability
Flow = 5 - 10 L/min

Flow rate of 5 L/min minimum so that CO2 gas can get flushed out of the mask.

24
Q

Oxygen Devices: Partial Breathing Mask
FiO2 Range
Flow Rate

A

FiO2 = 40% - 70% Variable stability
Flow = Minimum of 10 L/min

Flow rate of must be at least 10 L/min to prevent the bag from collapsing during inspiration

25
Q

Oxygen Devices: Non-Breathing Mask
FiO2 Range
Flow Rate

A

FiO2 = 60% - 80% Variable stability
Flow = Minimum of 10 L/min

Flow rate of must be at least 10 L/min to prevent the bag from collapsing during inspiration

26
Q

Oxygen Devices: Venturi Mask (AEM)
FiO2 Range
Flow Rate

A

FiO2 = 24% - 50% Fixed stability
Flow = Varies; should provide output flow >60 L/min

27
Q

Oxygen Devices: HFNC: Optiflow
FiO2 Range
Flow Rate

A

FiO2 = 21% - 100% Fixed stability
Flow = 5 - 60 L/min

  1. The flowmeter on the optiflow can go up to 70 L/min
  2. Heater Pot Temps: 31C Invasive - 37C Vasive. Start at 37C and work down to 31C if patient complains.
  3. Prongs on HFNC should not occlude more than 50% of patient’s nares.
28
Q

Oxygen Devices: HFNC: Vapotherm
FiO2 Range
Flow Rate

A

FiO2 = 21% - 100% Fixed stability
Flow = 5 - 40 L/min

29
Q

PEEP: Positive End Expository Pressure

A
  1. For every 10 L/min of air flow you get 1cm of PEEP
  2. Example: 60 L/min = 6 cm of PEEP
  3. PEEP is indicated when Pt’s oxygenation is not improving (Refractory hypoxemia)
  4. PEEP valve is placed on the Respiratory Valve on the AMBU Bag
  5. PEEP has a start value of 5cmH2O. 5 - 20 cmH2O is the range of PEEP given to patients.
30
Q

Total Flow: Patient on 50% VM running at 10 lpm

A

Liters Air/Liter O2 = (100-50) / (50-21) = 50/29 = 1.7
1.7 : 1 = 1.7 + 1 = 2.7
2.7 x 10 lpm = 27 lpm Total Flow

  1. Use 20 if desired O2 is greater than 40%
  2. Use 21 if desired O2 is less than 40%
  3. “Magic Box” Method
31
Q

Suction Pressure: Normal (adult, child, neonates)

A

Adult: 100 - 120 mmHg
Child: 80 - 100 mmHg
Neonate: 60 - 80 mmHg

RESP 101, Assessment and Caring for a Respiratory Patient (11 decks)

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