Pulmonary Diagnostic Procedures

Question 1

air= ___, and bone =____ on a chest x-ray

Answer 1

dark, white

Question 2

What term refers to what is present when normal line of demarcation between two structures is partially or completely obliterated?

Answer 2

silhouette sign

Question 3

What are some advantages and disadvantages to getting a CT?

Answer 3

advantages: much more sensitive, evaluates chest tube placement, evaluates lungs, heart, mediastinum, pleura, chest wall and abdomen
disadvantage: risk of transporting patient out of ICU, increased radiation, risk of intravenous contrast if given

Question 4

Normal pH is:
Acidosis is:
Alkalosis is:

Answer 4

normal-7.35-7.45
acidosis: less than 7.35
alkalosis: greater than 7.45

Question 5

Normal PaO2 is:
Abnormal is:

Answer 5

80-100 mmHg
abnormal- less than 80mmHg

Question 6

___ refers to the partial pressure of oxygen in arterial blood while ___ refers to the saturation of oxygen in arterial blood

Answer 6

PaO2, SaO2

Question 7

Hypoxemia levels PaO2
Mild:
Moderate:
Severe:

Answer 7

mild- 60-80 mmHg
moderate- 40-60 mmHg
severe- less than 40 mmHg

Question 8

This term refers to the partial pressure of carbon dioxide in the blood, why is it important?

Answer 8

PaCO2, reflects the adequacy of alveolar ventilation

Question 9

Normal PaCO2:
Abnormal:

Answer 9

normal: 35-45 mmHg
abnormal: less than 35 mmHg or greater than 45

Question 10

What could the patient be doing that would cause their PaCO2 to be abnormally high, low?

Answer 10

too high: patient might be HYPOventilating
too low: patient might by HYPERventilating

Question 11

For every 10mmHG increase in PaCO2, the pH should fall __ units

Answer 11

0.07

Question 12

Normal HCO3:

Answer 12

22-26 mEq/L

Question 13

What are 2 ways acidosis can occur?

Answer 13

low HCO3 produces metabolic acidosis
high PaCO2 produces respiratory acidosis (aka: alveolar hypoventilation and hypercapnia)

Question 14

What are 2 ways alkolosis occurs?

Answer 14

high HCO3 produces metabolic alkalosis
low PaCO2 produces respiratory alkolosis (alveolar hyperventilation or hypocapnia)

Question 15

Describe the process of metabolic acidosis and the compensation by the body?

Answer 15

primary fall in HCO3 resulting in a lower pH which then causes for pH to decrease and HCO3 decreases
compensation: decreasing PCO2 by hyperventilation (blowing off excess CO2 to bring pH back to normal)

Question 16

Describe the process of metabolic alkalosis and the compensation by the body?

Answer 16

Primary rise in HCO3 resulting in a higher pH, pH then increases and HCO3 increases
Compensation: increasing PCO2 by hypoventilation to bring pH back to normal

Question 17

Describe the process of respiratory acidosis and the body’s compensation

Answer 17

primary rise in PaCO2 with a resultant decrease in pH, pH decreases and PaCO2 increases
Compensation: retaining of bicarbonate by the kidneys in an effort to increase the pH

Question 18

Describe the process of respiratory alkalosis and the body’s compensation

Answer 18

Drop in PaCO2 with a resultant increase in pH, then pH increases and PaCO2 decreases
compensation: excretion of bicarbonate by the kidneys (body tries to excrete HCO3 to try and decrease pH)

Question 19

How do you determine if a problem is respiratory in nature vs metabolic in nature?

Answer 19

If there is a normal inverse relationship between pH and CO2 and that relationship is maintained, then it is respiratory in nature, if it is NOT maintained, it is metabolic in nature