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AFN Health Assessment > Pulmonary Assessment (ABG/CXR) > Flashcards

Pulmonary Assessment (ABG/CXR) Flashcards

1
Q

Most O2 in the blood is bound to Hgb ~ ___%

A

97%

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2
Q

Mild hypoxemia = PaO2 ___-___ mmHg

A

60-79 mmHg

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3
Q

Moderate hypoxemia = PaO2 ___-___ mmHg

A

40-59 mmHg

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4
Q

Severe hypoxemia = PaO2 < ___ mmHg

A

40 mmHg

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5
Q

pH can be calculated by the _________ __________ equation

A

Henderson Hassleback equation

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6
Q

Kidneys reabsorb ______ and eliminate ___

A

HCO3
H+

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7
Q

PaCO2 < 35 mmHg = respiratory ________

A

alkalosis

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8
Q

PaCO2 > 45 mmHg = respiratory ________

A

acidosis

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9
Q

Rapidly change PaCO2 by adjusting _______ _________

A

minute ventilation

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10
Q

Most frequent cause of airway obstruction?

A

Tongue

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11
Q

HCO3 > 26 mmHg = metabolic _________

A

alkalosis

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12
Q

HCO3 < 22 mmHg = metabolic _________

A

acidosis

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13
Q

Causes of ________ HCO3: vomiting, diuretic administration

A

Increased

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14
Q

Causes of ________ HCO3: hypoperfusion, ketoacidosis, renal failure

A

Decreased

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15
Q

_________ __________ is characterized by hyperbicarbonatemia (>27 mEq/L) and usually by an alkalemic pH (>7.45)

A

Metabolic alkalosis

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16
Q

Factors that generate metabolic alkalosis include vomiting and ________ administration

A

diuretic

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17
Q

Metabolic alkalosis is associated with ____-kalemia, ionized ____-calcemia, secondary ventricular arrhythmias, increased ______ toxicity, and compensatory _____-ventilation (hypercarbia), although compensation rarely results in PaCO2 above ___ mmHg

A

hypokalemia

hypocalcemia

digoxin

hypoventilation

55 mmHg

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18
Q

Etiologic therapy for metabolic alkalosis consists of measures such as expansion of ________ ________ and/or the slow administration of __________

A

intravascular volume

potassium

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19
Q

Nonetiologic therapy for metabolic alkalosis includes administration of __________ (a carbonic anhydrase inhibitor that causes renal bicarbonate wasting), and _______

A

acetazolamide

dialysis

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20
Q

Sufficient reductions in pH may reduce myocardial _________, increase ________ vascular resistance, and decrease _______ vascular resistance

A

contractility

pulmonary

systemic

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21
Q

________ should rarely be used to treat acidemia induced by metabolic acidosis

A

NaHCO3

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22
Q

In contrast to NaHCO3, _______ effectively reduces [H+], does not increase plasma [Na+], does not generate CO2 as a byproduct of buffering, and does not decrease plasma [K+]16; however, there is no generally accepted indication for ______

A

THAM (buffer tris-hydroxymethyl aminomethane)

THAM

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23
Q

Results from an increase in minute alveolar ventilation (VA) that is greater than that required to excrete metabolic CO2 production

A

Respiratory alkalosis

24
Q

_________ ________ ________ is tightly regulated and responds rapidly to changes in PaCO2

A

Cerebral blood flow (CBF)

25
Q

List 3 acute conditions that respiratory alkalosis can produce

A

-hypokalemia

-hypocalcemia

-cardiac dysrhythmias

-bronchoconstriction

-hypotension

-digoxin toxicity

26
Q

How do we typically tx respiratory alkalosis?

A

Treat underlying cause

27
Q

Occurs because of a decrease in alveolar ventilation and an increase in production of carbon dioxide.

A

Respiratory acidosis

28
Q

With acute respiratory acidosis, do we have HCO3- retention?

A

No

29
Q

With chronic respiratory acidosis, do we have HCO3- retention?

A

Yes

30
Q

Tx of severe acute respiratory acidosis

A

Mechanical ventilation

31
Q

low pH, high PaCO2, high HCO3

A

Partially compensated Respiratory Acidosis

32
Q

normal pH, high PaCO2, high HCO3

A

Fully compensated Respiratory Acidosis

33
Q

low pH, low PaCO2, low HCO3

A

Partially compensated Metabolic Acidosis

34
Q

normal pH, low PaCo2, low HCO3

A

Fully compensated Metabolic Acidosis

35
Q

high pH, low PaCO2, low HCO3

A

Partially compensated Respiratory Alkalosis

36
Q

Acute respiratory acidosis: for 10mmHg increase in PaCO2, the HCO3 will increase ~ __-__ mEq/L

A

1-2 mEq/L

37
Q

Chronic respiratory acidosis: for 10mmHg increase in PaCO2, the HCO3 will increase ~ __ mEq/L

A

5 mEq/L

38
Q

Base excess is highly negative, usually ______ related

A

volume related

39
Q

For every ___ units of CO2 above normal, the pH should inversely change by 0.1

A

10 units

40
Q

What is the calculated pH with a PaCO2 of 65 mmHg? (use 7.4 as normal)

A

7.2

41
Q

If the measured pH is lower than expected, we can assume there are other acids bring the pH down, e.g. _____ _______

A

lactic acids

42
Q

If the measured pH is better than the calculated, _______ __________ is probably occurring

A

renal compensation

43
Q

Normal base excess range?

A

-3 to 3

44
Q

Normal anion gap range?

A

8 - 12

45
Q

(high, low or normal AG albumin / globulin ratio?) affected by increases in unmeasured ions (acidosis) or affect of toxins

A

High AG

46
Q

(high, low or normal AG?) HCO3- is lost externally

A

Low AG

47
Q

Name 3 causes of high AG acid/base imbalance

A

Uremia

lactic acidosis

ketoacidosis

48
Q

Name 3 causes of normal AG acid/base imbalance

A

Renal tubular acidosis

diarrhea

administration of carbonic acid inhibitors

HCL administration

ureteral diversions

49
Q

(partially or fully compensated system) Opposing system will be outside the normal range in the direction opposite the problem

A

partially compensated system

50
Q

(partially or fully compensated system) Metabolic and respiratory systems will both be outside of range

A

fully compensated system

51
Q

A normal or slightly low HCO3- in the presence of hypercapnia suggests a ________ metabolic _______

A

concomitant

acidosis

52
Q

A normal or slightly elevated HCO3- in the presence of hypocapnia suggests a ________ metabolic ________

A

concomitant

alkalosis

53
Q

Lung markings more prominent in _______ ________ and decreased in ____________

A

chronic bronchitis

emphysema

54
Q

Antero-posterior diameter increased in _______

A

COPD

55
Q

Flattened diaphragm in ______

A

COPD

56
Q

Know how to read CXRs (refer to slide 30 on PP to see what we need to be able to identify)

A

Know it bro

57
Q

List the ABCDEF method of reading CXRs

A

A: airways: trachea, R & L main bronchus
B: bones and soft tissue: ribs, clavicles, sternum, spine/vertebral bodies
C: cardiac silhouette / mediastinum (cardiomegaly)
D: diaphragm: R & L hemidiaphragm (curved)
E: everything else or effusions and pleura and costophrenic angles, gastric bubble
F: lung fields: fissures, lobes (R x 3, L x 2)

Also,
Lines, tubes, devices, surgeries (sternal wires)

AFN Health Assessment (12 decks)

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