resp alterations

Question 1

classic sign of ARDS, ARF, and ALI

Answer 1

hypoxemia unrelieved with oxygenation–> needs intubation and long-term support

Question 2

normal pH?

Answer 2

7.35-7.45

Question 3

normal PaO2:

Answer 3

80-100

Question 4

normal PCO2:

Answer 4

35-45

Question 5

normal HCO3:

Answer 5

22-26

Question 6

AACN definition of what constitutes ARF?

Answer 6

oxygen <60 and PCO2>45

Question 7

The amount of blood circulating through the lungs that does not participate in gas exchange

Answer 7

shunt

Question 8

To estimate the amount of shunt through the lungs, what’s the forumla

Answer 8

divide the patient PaO2 by the FiO2

P/F Ratio Normal: > 300

Question 9

1st sign of impending resp failure

Answer 9

mental changes (agitation, confusion

Question 10

early vs late signs of resp failure

Answer 10

early (mental changes, and tachypnea)

late (cyanosis and hypoxia)

Question 11

initial management for resp failure:

Answer 11

• improve oxygenation
• bronchodilators, corticosteroids, antibiotics, diuretics
• maintain cardiac output of SBP>90 and MAP>60
• keep hemoglobin >9
• prepare for intubation (anxiety–>ativan, propofol)

Question 12

hypoxemic resp failure parameters:

Answer 12

Oxygenation Failure

PaO2 < 60 mmHg on FIO2 of 60%

Question 13

hypercapnic resp failure parameters:

Answer 13

Ventilatory Failure

PaCO2 > 45 mmHg and pH < 7.35