Oxygen supply and demand workshop Flashcards
1
Q
Preload assessment (6)
A
CVP JVD Breath sounds (crackles indicate fluid overload) Heart sounds (extra S3 or S4) blood loss dry mucous membranes
2
Q
Normal CVP
A
2-6
3
Q
Afterload assessment (6)
A
dBP Pulse pressure cap refill pulses skin warmth and colour, Hct (blood viscosity)
4
Q
Contractility assessment
A
Cardiac history (ie heart failure) Preload (increased preload equals increased contractility except in heart failure) Electrolytes
5
Q
Stroke volume assessment
A
look at preload, after load and contractility
6
Q
Heart rate
A
Is it increased as a compensatory mechanism?
7
Q
Ventilation assessment
A
RR WOB TV (breathing shallow or deep) AE - decreased AE =?atelectasis PCO2
8
Q
normal PCO2
A
35-45
9
Q
Oxygentation assessment
A
O2 sat PaO2 VQ mismatch Diffusion- AC membrane thickness( crackles or consolidation) Driving pressure- are they on FiO2?
10
Q
O2 transport
A
Hgb level
Oxy Hgb disociation curve
11
Q
O2 demand
A
pain temp HR RR/WOB Stress
12
Q
Things that shift the oxy hemoglobin curve to the Right
A
Increased temp
Increased H+ (low PH)
Increased CO2 (hypoventilation)
13
Q
Things that shift the oxy hemoglobin curve to the Left
A
Decreased temp
Decreased H+ (high PH/ aLkalosis)
Decreased CO2 (hyperventilation)
14
Q
How do we assess overall end organ perfusion
A
Lactate (norm <2)
ScvO2 (norm 60-80%)
O2ER
15
Q
Pulse pressure
A
> 30 is wide
<30 is narrow
