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Crt Study Guide > Patient Data > Flashcards

Patient Data Flashcards

1
Q

Ph

A

(7.35-7.45)

Important to diagnose diabetes and may be a indication for sodium administration

Determine CO2 retainer (COPD) if pH is normal when PaCO2 is high = COPD

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2
Q

PaCO2^45 (35-45)

A

Not ventilating

You use to correct it

  • Ippb
  • mechanical ventilation
  • manual resuscitation (bag)
  • bipap
  • mouth to mouth
  • pressure support ventilation (PSV)
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3
Q

Below PaO2< 80. (80-100)

A

Means the patient is not oxygenating

Intervention is needed

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4
Q

Low HCO3 (22-26)

A

Clear indication for sodium bicarbonate administration

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5
Q

Hb (12-16)

Difference between low Hb and high Hb

A

If Hb is low the patient is hypoxic regardless of PaO2 and SaO2 so give blood

High Hb above 16 is called polycythemia found in COPD pt’s

Hemorrhaging is a indication of blood loss and indicates supplemental blood should be given!

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6
Q

VD/VT (20-40%)

Acceptable up to 60% if on a ventilator

A

The only calculation that relates to ventilation

Represents the percentage of the tidal volume that is unavailable for gas exchange

VD/VT=(PaCo2- PECo2)/ PaCo2 x100

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7
Q

High dead space VD/VT

A

Relates to pulmonary embolus

PaC02 value comes from blood gas

PECO2 comes from end-tidal CO2 monitor (infrared device or capnography) or the Douglas bag

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8
Q

Tube position

A

Tube position should always be

2cm - 1 inch above the carina or at the aortic knob/notch

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9
Q

Instillation of medication

A

Navel

 Narcan.-          Narcotic overdose 
Atropine-         Bradycardia 
Valium/versed- Sedative 
Epinephrine-     Asystole
Lidocaine-         PVC
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10
Q

Sinus Arrhythmia

A

Sinus rhythm with irregular rate

Treatment- treat any other symptoms

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11
Q

Sinus tachycardia

A

Sinus rhythm with a rate above 100

Treatment- give oxygen

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12
Q

Sinus bradycardia

A

Sinus rhythm with a rate below 60

Treatment- oxygen, atropine

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13
Q

PVC

A

Premature ventricular contractions

Treatment- oxygen lidocaine

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14
Q

MPVC

A

Multifocal premature ventricular contractions

Treatment- oxygen, lidocaine

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15
Q

V-tach

A

Ventricular tachycardia rhythm with a rate above 100

Treatment- defibrillate (if no pulse), lidocaine & (cardiovert if pulse is present)

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16
Q

V-fib

A

Ventricular fibrillation is a completely irregular ventricular rhythm

Treatment- defibrillate

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17
Q

Asystole

A

Treatment-Confirm in 2 leads first, epinephrine, atropine, CPR

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18
Q

1st degree heart AV block

A

PR interval above .20 (measured from the beginning of P wave to the beginning of the QRS

Maybe due to ischemia or digitalis

Treatment-atropine

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19
Q

2nd degree AV block

A

Irregular rhythm normal P waves but the QRS complex is missing

Treatment- atropine, electrical pacemaker

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20
Q

3rd degree AV block

A

Atrial rate above 60…. ventricular rate below 40/minute
PR interval cannot be determined; QRS complex will be widened

Treatment- electrical pacemaker

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21
Q

Ischemia

A

Reduced blood flow to tissue

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22
Q

Inverted T waves

A

Can also be caused by digitalis toxicity and hypokalemia

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23
Q

Injury indication

A

Injury is indicated by an elevated S-T segment

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24
Q

Infarction diagnosis

A

Infarction diagnosed by significant Q waves

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25
Q

Hyperkalemia

A

Will cause elevated or spike T waves

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26
Q

Secretions in lower lobes part of the lunges

A

put pt head down

Secretions in higher

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27
Q

Indications:

Coughing helps us get the gunk up and out

A 
Impaired mucociliary transport
Excessive pulmonary secretions
*(pts who have Chronic Bronchitis &amp; Cystic Fibrosis) 
Ineffective cough
Absent cough
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28
Q

CaO2

A

(17-20%)
Oxygen molecules in the atrial blood

Can be reduced by low Hb anemia or CO

CaO2 has the best relationship to tissues oxygenation

CaO2=(Hb x 1.34)

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29
Q

CvO2

A

(14-16%) Oxygen retuning to the right side of the heart

Best place to obtain mixed venous blood is from the pulmonary artery

Decreasing values relate to decreasing cardiac output

Mixed venous oxygen content

CvO2=Hb

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30
Q

C(a-v)O2

Arterial-venous oxygen content difference from

A

(4-5 vol%)
C(a-v)O2= CaO2 - CvO2

Value increases as C.O decrease. (Inverse relationship)

CvO2 is dropping, cardiac output is decreasing. If the SVO2 or PVO2 is dropping while the arterial counterparts (SaO2 & PaO2) remain steady reduction of cardiac output can be assumed

Measure the oxygen consumption of the tissue

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31
Q

PAO2

Alveolar oxygen tension

A

PAO2=((PB-PH2O)FIO2)- PaCO2/0.8

The alveolar air equation is the method for calculating partial pressure of alveolar gas (PAO2). The equation is used in assessing if the lungs are properly transferring oxygen into the blood.

Shortcut: PAO2=(O2%x7)-(PaCO2+10)

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32
Q

A-a Gradient

A

A-aDO2= PAO2- PaO2
(25-65 mm Hg)

Above 65 but less than 300 mm Hg= V/Q mismatch

Above 300 mm Hg= shunt (venous admixture)

Get value on 100% FIO2

Hypoxemia - cause interpretation

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33
Q

P/F Ratio

A

(PaO2/FIO2)

Normal is 380 or greater

300 or less signifies Acute lung Injury (ALI)

200 or less signifies Acute Respiratory Distress Syndrome (ARDS)

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34
Q

Oxygen Index (OI)

A

(Mean airway pressure x %oxygen) / PaO2

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35
Q

Fluffy infiltrates

A

Pulmonary edema

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36
Q

Tracheal shift from midline

A

Pneumothorax, hemothorax, significant atelectasis

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37
Q

Obliterated costophrenic angles

A

Pleural effusion

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38
Q

Flattened diaphragm

A

COPD, significant air trapping

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39
Q

Wedge shaped infiltrates

A

Pulmonary embolism

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40
Q

Butterfly or bat wing

A

Pulmonary edema

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41
Q

Plate like or patchy infiltrates

A

ARDS, or atelectasis

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42
Q

Scattered patchy infiltrates

A

ARDS

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43
Q

Ground glass or honeycomb pattern

A

ARDS or IRDS

44
Q

Reticulogranular or granular pattern

A

ARDS or IRDS

45
Q

Concave superior border or interface

A

Pleural effusion

46
Q

Consolidation or haziness

47
Q

Sudden onset of shortness of breath

A

Pulmonary embolus

48
Q

Steeple sign lateral neck x-ray

A

Croup (laryngotracheobronchitis)

49
Q

Tachycardia

50
Q

(Thumb sign) lateral neck x-ray

A

Acute epiglottitis

51
Q

Flat to percussion

A

Atelectasis

52
Q

Cold clammy skin

A

Myocardial infarction

53
Q

Fine rales

A

CHF & pulmonary edema

Diurese the patient, cardiac medications, positive pressure ventilation

54
Q

Venous distension

55
Q

Decreased flows
FEV1/FVC%
FEV1, FEF25-75
FEF 200-1200

A

Obstructive pulmonary disorder

56
Q

Pt

Prothrombin time

A

Warfarin (Coumadin)
Therapy
Heparin therapy

57
Q

3 layer Sputum

A

Bronchiectasis

58
Q

Retraction

A

Infant respiratory distress

59
Q

PTT

Partial Thromblastin time

A

Heparin therapy

60
Q

Sudden onset tachypnea

A

Pneumothorax

61
Q

Hyperresonant to percussion

A

Pneumothorax

62
Q

Medium rales

A

Secretions in mid-size airways

Any therapy to mobilize secretions (IPPB, SMI, PEP, CPT)

63
Q

Chest movement without nasal flow

A

Obstructive sleep apnea

64
Q

Double lumen endotracheal tube

A

Independent lung ventilation

After lung surgery, transplant, or with lung cancer

65
Q

Hypernatremia

A

Dehydration

66
Q

Angry, irritable combative

A

Electrolyte imbalance

67
Q

Pitting edema

68
Q

Hyperlucency

A

Excess pulmonary air

COPD, Asthma, Pneumothorax

69
Q

Dull to percussion

A

Fluid filled

Pneumonia or pleural effusion

70
Q

Pulses paradoxus

A

Severe air trapping

As seen in status asthmaticus

71
Q

Consolidation

Chest x ray

A

Heavy collection of infiltrates

72
Q

Ashen or pallor

A

Anemia or acute blood loss

73
Q

Diaphoresis

A

Heart failure

74
Q

Opaque

Chest x ray

A

Fluid filled lungs

75
Q

No chest movement without nasal flow

A

Central sleep apnea

76
Q

Pleural friction rub

A

Tuberculosis, lung cancer,

Pulmonary infarction

77
Q

General malaise

A

Electrolyte imbalance

78
Q

Pronounced Q waves

A

Previous myocardial infarction

With tissue death

79
Q

Struporous confused

A

Drug overdose

80
Q

Weakness in legs

Lower extremities

A

Gullain Barre

Syndrome

81
Q

Bronchogram

A

Bronchiectasis

82
Q

Minimum spontaneous tidal volume (to sustain life)

83
Q

Minimum vital capacity (to sustain life)

84
Q

Unilateral wheezing

A

Lung mass or foreign body in lungs

85
Q

Elevated eosinophil count

86
Q

Reticulgranular pattern on x ray

A

ARDS, IRDS

87
Q

Lethargic sleepy, somnolent

A

CO2 overdose

88
Q

Marked or severe

A

Emergent condition

89
Q

Flattened t waves

A

Hypokalemia

90
Q

Vascular markings

A

Increased with CHF absent with pneumonia

91
Q

Spiked t waves

A

Hyperkalemia

92
Q

H cylinder tank factory

93
Q

Drooping eyelids double vision dysphagia

A

Myasthenia gravis

94
Q

Purulent sputum

A

Chronic bronchitis

95
Q

Tree in winter pattern chest x ray

A

Bronchiectasis

96
Q

Paradoxical chest movement

A

Fail chest

Ribs broken in multiple places

97
Q

Kussmaul’s breathing

A

Metabolic acidosis, diabetes, renal failure

98
Q

Mucoid sputum

A

Chronic bronchitis

99
Q

E cylinder tank factor

100
Q

Radiolucent

A

Normal lungs

101
Q

Rhonchi (course rales)

A

Mucus in large airways

Suctioning, cough coaching and anything to mobilize secretions

102
Q

Night sweets

A

Tuberculosis

103
Q

Spag unit

Small particle aerosol generator

A

Deliver Ribavirin for RSV

104
Q

5 obstructive diseases

A 
Chronic bronchitis 
Emphysema 
Bronchiectasis 
Asthma 
cystic fibrosis
105
Q

Minimum MIP (to sustain breathing)

106
Q

Myasthenia gravis

A

Descending (mind to ground)

Positive tensilon test
Monitor VC/MIP (serial testing)

Drugs: neostigmine, pyridostigmine
Intubation/ mech vent- short term

107
Q

Gullain barre syndrome

A

Ascending (ground to the brain)

Spinal tap- protein in spinal fluid
Monitor VC/MIP

Drugs: steroids, prophylactic, antibiotics
Mech vent/ trach- long term
Plasmapheresis

Crt Study Guide (1 decks)

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