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Cardiopulmonary PT > Oxygen saturation and Arterial Blood gasses > Flashcards

Oxygen saturation and Arterial Blood gasses Flashcards

1
Q

What is oxygenation dependent on

A
  • amount of hemoglobin
  • partial pressure of oxygen
  • amount of oxygen bound to hemoglobin
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2
Q

What will best measure oxygenation

A
  • CBC hemoglobin as it measure oxygen and hemoglobin
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3
Q

Signs and symptoms of hypoxia

A
  • cyanosis - central vs peripheral
  • tachycardia/arrhythmias
  • peripheral vasoconstriction
  • poor judgement/motor incoordination/slow reaction time
  • restlessness/agitation/confusion
  • fatigue
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4
Q

How is tachycardia a sign or hypoxia

A
  • to increase CO
  • since you can’t pick up as much each “load” you need more loads
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5
Q

Central cyanosis vs peripheral cyanosis

A
  • central: related to low oxygen and seen around the lips, tongue, nail beds (mucus membranes where capillary beds are close to the surface
  • Peripheral: poor perfusion ie during cold air
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6
Q

How to assess oxygenation status

A
  • indirect: assessment of oxygen saturation of the blood (pulse oximetry)
  • direct: sampling of arterial blood (ABGs)
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7
Q

SpO2

A
  • measures oxygen saturation indirectly via pulse oximeter
  • LED that detects the absorption of red light
  • impacted by cold hands, nail polish, hypoxia, device malfunction, darker skin
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8
Q

SaO2

A
  • measures oxygen saturation directly from blood sample
  • ABGs
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9
Q

PaO2

A
  • partial pressure of oxygen (mmHg)
    directly from a blood sample (ABG)
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10
Q

Oxygen saturation and partial pressure normal values and abnormal values

A

Normal:
- PaO2: 80-100 mmHg
- >95%

Mild hypoxia:
- 60-80 mmHg
- 90-95%

Moderate hypoxia:
- 40-60 mmHg
-80-90%

Severe hypoxia
- <40 mmHg
- <80% severe hypoxia

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11
Q

Oxyhemoglobin dissociation curve shifted to the right is caused by

A
  • increased temperature (body)
  • increased PCO2
  • decreased pH
  • O2 unloads quicker/decreased affinity for O2
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12
Q

Oxyhemoglobin dissociation curve that is shifted to the left is caused by

A
  • decreased temperature
  • decreased PCO2
  • increased pH
  • increased affinity for O2
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13
Q

Normal arterial blood gas values
1. PaO2:
2. PaCO2
3. pH
4. HCO3
4. SaO2 (oxygen saturation

A
  1. PaO2: 80-100 mmHg
  2. PaCO2: 35-45 mmHg
  3. pH: 7.35-7.45
  4. HCO3: 22-26
  5. SaO2 (oxygen saturation): 95-99%
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14
Q

Arterial blood gases/blood gas analysis - oxygenation

How is it done and what does it look at

A
  • typically through A-line due to needing multiple measurements
  • drive intervention + realists of intervention
    Looks at:
  • Arterial pH
  • PaCO2
  • PaO2
  • HCO3
  • SaO2
  • oxygenation status is determined by the PaO2 and oxygen saturation SaO2
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15
Q

When does hypoxemia occur

A
  • when PaO2 is <60mmHG and SaO2/SpO2 <90%
  • patient with resting SaO2/SpO2 <90% usually require supplemental oxygen during exertion to avoid further desaturation
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16
Q

Oxygen titration order

A
  • MUST be prescribed by an MD
  • Can only function within the MD’s orders
  • DO NOT increase oxygen without an order
17
Q

Arterial blood gases/blood gas analysis of acid base

A
  • arterial pH
  • PaCO2
  • PaO2
  • HCO3
  • Oxygen saturation
  • acid base balance determined by pH, bicarbonate and PaCO2
18
Q

Acidic state vs alkalotic state

A
  • acidic state exists from TOO much CO2 or too little HCO3
  • alkaloid state can exist from either TOO little CO2 or too much HCO3
19
Q

Acidosis/acidemia

A
  • pH <7.4
  • decreased bicarbonate = metabolic acidosis
  • increase PaCO2 = respiratory acidosis (aka, alveolar hypoventilation or hypercapnia)
20
Q

Alkalosis/alkalemia

A
  • pH >7.4
  • increase bicarbonate = metabolic alkalosis
  • decreased PaCO2 = respiratory alkalosis (aka - alveolar hyperventilation or hypocapnia)
21
Q

Metabolic acidosis: what and how

A
  • pH<7.4; HCO3 decreased
  • acid accumulation from metabolic processes or loss of HCO3
    causes:
  • ketoacidosis
  • lactic acidosis
  • renal failure
  • diarrhea (excrete bases)
22
Q

Metabolic acidosis signs and symptoms

A
  • lethargy
  • confusion
  • headahce
  • nausea
  • vomiting
23
Q

metabolic acidosis treatment

A
  • monitor and treat underlying cause
24
Q

Metabolic alkalosis: what and how

A
  • pH>7.4 or increase in HCO3
  • acid loss or gain of too much base
    causes:
  • acid loss due to vomiting
  • ingestion of alkali (antacids)
25
Q

Metabolic alkalosis: signs and symptoms

A
  • dysrhythmias, dizziness, irritability
  • muscle cramps, twitching, spasms, paresthesia, numbness, tingling
  • compensatory hypoventialtion
26
Q

Metabolic alkalosis treatment

A
  • monitor and treat underlying cause
27
Q

Respiratory alkalosis: what and how

A
  • pH>7.4; PaCO2 <35 mmHg
  • hyperventilation

Causes:

  • pain
  • anxiety
  • fear
  • stress
  • high altitude
  • brain injury
  • improper ventilation during anesthesia or ventilation
28
Q

Respiratory alkalosis: signs and symptoms

A
  • tachypnea
  • SOB
  • lightheadedness
  • numbeness/tingling of extremities
  • muscles spasms
  • difficulty concentrating
29
Q

Respiratory alkalosis:Treatment

A
  • monitor and treat underlying cause
  • slow down breathing or breathe into paper bag
  • rebreather oxygen mask
  • sedation
30
Q

rebreather oxygen mask

A
  • bag is attached and therefore you rebreathe some expired air which has CO2
31
Q

Respiratory Acidosis: what and how

A
  • pH <7.4; PaCO2 >45mmHg
  • hypoventilation

causes

  • lung disorders
  • sleep disordered breathing
  • diseases that impair breathing (COPD = not exhaling adequately and therefore retaining CO2)
  • drugs overdose
  • sepsis
32
Q

Respiratory Acidosis: signs and symptoms

A
  • dyspnea
  • disorientation
  • coma
  • headache
  • drowsiness
  • hypoxemia/ hypercapnia
33
Q

Respiratory Acidosis: treatment

A
  • monitor and treat underlying cause
  • support ventilation if necessary
34
Q

Rules to remember with acidotic states and alkalotic states

A
  • pH determines acid/alkaline states
  • CO2 has an inverse relationship with pH
  • HCO3 has a direct relationship with pH
35
Q

Respiratory failure

A
  • arterial blood pH<7.35 with PaCO2>45
    OR
  • hypoxemia PaO2<60mmHg
  • not relieved with O2 = may need ventilator
36
Q

Types of respiratory failure

A
  • lung failure
  • pump failure
37
Q

lung failure

A
  • type 1 hypoxemic respiratory failure
  • PaO2 <60 mmHg
  • ventilation/perfusion mismatch - EX: pulmonary edema
  • deadspace and shunt
38
Q

pump failure

A
  • type 2 hypercapnia respiratory failure
  • reduced breathing effort
  • resistance to breathing ex: COPD
  • respiratory pump is impacted mechanically
  • PaCO2 >45 mmHg and pH <7.35

Cardiopulmonary PT (25 decks)

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