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Cardiopulm JD > PFTs And ABGs > Flashcards

PFTs And ABGs Flashcards

1
Q

What is abnormal increased CO2 level in the blood called?

A

Hypercarbia

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2
Q

What is decreased O2 in blood called?

A

Hypoxemia

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3
Q

PaO2 is the O2 in blood that is dissolved in what?

A

Plasma

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4
Q

The bulk of O2 is carried bound to ______

A

Hemoglobin

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5
Q

If you are not ventilating enough, and not blowing off enough Co2, CO2 goes ____ and pH goes ____

A

CO2 goes up

pH goes down

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6
Q

Respiratory acidosis is when the CO2 goes ___ and pH goes ____

A

Co2 goes up and pH goes down

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7
Q

Respiratory alkalosis is when you are hyperventilating, so pH goes ____

A

UP

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8
Q

6 steps of normal mechanism of breathing

A

1) Chemoreceptors (carotid arteries and aorta) respond to changes in blood chemicals
2) Signals sent to medulla as PaO2 and PaCO2 change
3) Medulla sends signal to respiratory muscles to contract C3-5 phrenic nerve –> innervates diaphragm
4) Thorax expands and diaphragm contracts
5) Transpulmonary pressure gradient changes
6) Air moves from a/w to alveoli

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9
Q

O2 in alveoli diffused into blood for PaO2 of ______ mmHg

A

80-100

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10
Q

CO2 in blood diffused into alveoli for PaCO2 of _____mmHg

A

35-45

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11
Q

Examples of restrictive defects are…

A

Neuromuscular, morbid obesity, and circumferential burns

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12
Q

Examples of obstructive defects are….

A

Asthma and COPD

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13
Q

Examples of diffusion deficits are…

A

Pulmonary Fibrosis (idiopathic)

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14
Q

Examples of shunt are….

A

Atelectasis, ARDS

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15
Q

When you are looking at lung volume and capacities, what kind of lung issues are you looking at?

A

Restriction

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16
Q

Tidal volume (VT) definition and what is the value?

A

Normal breath

Approx. 500 ml

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17
Q

Inspiratory reserve volume (IRV) definition and what is the value?

A

Volume above normal inhalation

Approx. 3 L

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18
Q

Expiratory reserve volume (ERV) definition and what is the value?

A

Addition volume exhaled after normal exhalation

1.2 L

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19
Q

Residual volume (RV) definition and what is the value?

A

Volume remaining in lungs after complete exhalation

1.2 L

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20
Q

What are the four measurements for volumes?

A

Tidal volume, inspiratory reserve volume, expiratory reserve volume, residual volume

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21
Q

What are the 4 capacity measurements?

A

Total lung capacity, vital capacity, inspiratory capacity, functional residual capacity

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22
Q

Total lung capacity (TLC) definition and values

A

IRV + VT + ERV + RV

Approx 5 L to 6

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23
Q

Vital capacity (VC/FVC/SVC) definition and values

A

IRV + VT + ERV

Approx. 4.8 L

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24
Q

Inspiratory capacity: definition and values

A

IRV + VT

Approx 3.5 L

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25
Q

Functional residual capacity: Definition and value

A

Ant left in lungs after normal respiration= approx 2.4 L

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26
Q

When using flows as your measurement, what kind of lung problem is this a primary measure of?

A

Obstruction

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27
Q

FEV1% definition and what value is considered obstructive?

A

% of FVC exhaled in 1 second –> maximal in, how much you can blow out

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28
Q

FEF definition

A

Forced Expiratory flow - 25-75% is normal, you are looking at middle capacity. Done in intervals: 0.5, 1, 2, 3 seconds

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29
Q

What is a body plethysmograph?

A

Used to estimate the residual volume

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30
Q

How is peak flow measurement measured?

A

The maximum flow during a forced expiration as measured by a handheld peak flow meter. Used to monitor asthma patients’ airway tone

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31
Q

What kind of disorder has decreased flow and increased volume/capacities (air trapping)

A

Obstructive

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32
Q

What kind of disorder has decreased volumes/capacities and normal or increased flows

A

Restrictive

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33
Q

With VT, RV, FRC, and TLC the values go ____ with obstructive and _____ with restrictive

A

Up

Down

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34
Q

Interpreting flows: Normal value for FVC

A

> 80

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35
Q

Interpreting flows: Normal value for FEV1/FVC%?

A

> 75

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36
Q

Interpreting flows: What happens to FVC with obstructive disease?

A

N or decreases

37
Q

Interpreting flows: What happens to FEV1/FVC% with obstructive disease?

A

Decreases

38
Q

Interpreting flows: What happens to FVC with restrictive disease?

A

Decreases

39
Q

Interpreting flows: What happens to FEV1/FVC% with restrictive disease?

A

N or increases

40
Q

What is DLCO?

A

Diffusion capacity of CO (small amounts- binds to hemoglobin very tightly

41
Q

What is the normal value of DLCO?

A

25-30 mL CO/min/mmHg

42
Q

What two things affect DLCO?

A

Hemoglobin and surface area

43
Q

DLCO would be low with…

A

Destruction of alveolar capillary membrane

Pulmonary fibrosis and emphysema

44
Q

People with emphysema have a decreased _____

A

Diffusing capacity

45
Q

How do you calculate % predicted and % change?

A

Actual/normal x 100

46
Q

For pre and post bronchodilator, what percent improvement post-Tx suggests a reversible component? And what percent is considered significant?

A

15%

10-20%

47
Q

COPD is ______ reversible

A

Minimally

48
Q

Asthma has a _____ component

A

Reversible

49
Q

What are examples of upper/large airway obstruction?

A

Obstructive sleep apnea
Tracheal stenosis
Extrinsic airway compression (tumor)

50
Q

What are some examples of restrictive diseases of the chest wall/pleura

A

Kyphoscoliosis

Obesity

51
Q

What are some examples of restrictive LUNG diseases

A

Idiopathic pulmonary fibrosis and sarcoidosis

52
Q

When the FEV1 is supposed to be 4.0 but you see that it is 2.0, is the disorder obstructive or restrictive?

A

Obstructive

53
Q

When you see that the DLCO is 1/2 of normal value, what kind of disorder is it?

A

Restrictive

54
Q

3 indications for ABGs

A

Determine:

1) Adequacy of ventilation
2) Adequacy of oxygenation
3) Metabolic status

55
Q

What kind of disorders would you be determining adequacy of ventilation for?

A

Neuromuscular, COPD, “code”

56
Q

What kind of disorders would you be determining adequacy of oxygenation for?

A

ARDS, PE, Pneumonia

57
Q

What kind of disorders would you be determining metabolic status for?

A

Kidney failure, sepsis, ketoacidosis, S/P code blue

58
Q

A status code blue: a patient is in full cardiac arrest, so what happens to CO2 and O2?

A

CO2 inc

O2 dec

59
Q

Where would you draw an ABG in adults?

A

Radial artery

60
Q

For the modified Allen’s test, how many seconds for a flush is a good indication of collateral circulation

A

15 seconds

61
Q

When doing a modified allens test, how long does it take for the hand to turn pink again?

A

3-5 seconds

62
Q

What is the typical representation in Pt record for ABGs?

A

PH/PCO2/Po2/HCO3/BE

63
Q

Normal values of pH

A

7.35-7.45

64
Q

Normal values of PCo2

A

35-45 torr

65
Q

Normal values of PO2

A

80-100 torr

66
Q

Normal values for HCO3

A

22-26 meq

67
Q

Normal values for BE (base excess)?

A

-2 to +2

68
Q

Normal values for SO2?

A

95-100%, same or similar to pulse Ox reading

69
Q

What is the order that you should evaluate ABGs?

A

pH
PCO2
HCO3
Oxygenation Status

70
Q

What is acidemia for pH?

A

<7.35

71
Q

What is alkalemia for pH?

A

> 7.45

72
Q

What is respiratory acidosis for PaCO2?

A

> 45

73
Q

What is respiratory alkalosis for PaCO2?

A

<35

74
Q

What is metabolic acidosis for HCO3?

A

<22

75
Q

What is metabolic alkalosis for HCO3?

A

> 26

76
Q

What is metabolic acidosis for BE?

A

< -2

77
Q

What is metabolic alkalosis for BE?

A

> +2

78
Q

If you have a PCO2 of >45 torr, what is going on?

A

Respiratory acidosis
CO2 retention
Hypoventilation

79
Q

If you have a PCO2 of <35 torr, what is going on?

A

Respiratory alkalosis

Hyperventilation

80
Q

Be is a function of what measure?

A

HCO3

81
Q

If the initially change is increased PCO2, what happens to HCO3?

A

This is resp acidosis, and HCO3 increases also

82
Q

If the initially change is decreased PCO2, what happens to HCO3?

A

This is resp alkalosis

HCO3 will also decrease

83
Q

What values indicate hypoxemia?

A

PO2 = <75-80 torr

84
Q

What are the mild hypoxemia values?

A

67-75 torr PO2

85
Q

What are the moderate hypoxemia values?

A

PO2 of 50-65 torr

86
Q

What are the severe hypoxemia values?

A

PO2 < 50 torr

87
Q

Hyperoxia is indicated with what value?

A

100-120 torr

88
Q

Uncompensated means?

A

pH is not in normal range

Cardiopulm JD (12 decks)

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