Respiratory Flashcards

1
Q

Alveolar ventilation calculation

A

TV x 0.35 x RR

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2
Q

Pressure control - what is variable?

What type of dz process to be used in?

A

Pressure fixed
Tidal volume is variable
TIny creatures or primary lung dz (don’t want to blow out the lungs on accident)

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3
Q

Cyanosis does not appear until PaO2 is what?

A

50 or less

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4
Q

Normal minute volume

A

150-250ml/kg/min

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5
Q

Is CO2 or O2 more soluble?

A

CO2 is 20x more soluble than O2

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6
Q

Patient on 100% O2 should have PaO2 of what?

A

300-500mmhg (99-100% SpO2)

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7
Q

Phase 2 of ARDS (proliferative) there is an overproduction of what? Causing what?

A

Type II pneumocytes - go crazy producing surfactant leading to pulmonary hypertension and more edema

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8
Q

PaO2 = what? (small a)

A

aterial

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9
Q

During the 1st phase of ARDS (exudative) , Type I and Type II pneumocytes are damaged. What does each do? Then what happens?

A

Type I - exchange gas
Type 2 - produce surfactant

Causes edema

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10
Q

Spo2 of 90-91% correlates to what PaO2?

A

60mmhg

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11
Q

Setting PIP alarms is super important during what mode?

A

VOLUME control - don’t blow the patient up

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12
Q

Higher levels of PEEP can lead to what?

A

decreased cardiac output

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13
Q

PA02 = what? (big A)

A

Alveolar

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14
Q

What is TRALI and when does it occur?

A

Transfusion related ALI

6 hours post transfusion

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15
Q

Normal PvO2
When do they need O2?
When is it emergency?

A

Normal 40 mmhg
30 needs O2
20 emergent

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16
Q

A-a gradient - 0-10 is what?

A

normal

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17
Q

SaO2 = what?

A

Saturation of O2 on Hemaglobin

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18
Q

Mandatory vs spontaneous breaths

A

Mandatory - machine controlled

Spontaneous - patient controlled

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19
Q

SIMV -
What is it?
What is it good for?

A

Good for weaning

Let patient breaths be (no support) but machine ensures # of breaths are there

any machine initiated are full breaths

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20
Q
  • Decreased pleural space
  • ETT obstruction
  • Excessive dead space

Can all lead to what change in CO2?

A

ELEVATED

CO2

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21
Q

Normal PaO2/FiO2 RATIO

A

476

100/0.21

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22
Q

E-collar O2 “hoods” should be what percent covered?

Where should the opening be?

A

75%

Top 1/4

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23
Q

Volume control - what is fixed and what is variable?

A

Tidal volume is fixed

Pressure becomes variable

24
Q

ARDS acts like ____________, only in the lungs

A

sepsis - leaky vessels, hyperinflammation

25
Q

A-a gradient >31 means what

A

O2 warranted

26
Q

Aspiration pneumonia typically doesn’t show up radiographically until ___________

A

12-36 hours post aspiration

27
Q

ARDS mortality rate in vet med

A

90-100%

yikes

28
Q

Spo2 of 95-96% correlates to what PaO2?

A

80mmhg

29
Q

Approx what % of minute volume is DEAD space?

A

35%

30
Q

Options to adjust for HIGH CO2
Rate?
Volume?
Peep?

A

Breathe off that CO2

  • Increase Rate
  • Increase Volume
  • Decrease PEEP
31
Q

oxyhemoglobin disc curve

what is on what axis>?

A
Sao2 l
          l
          l
          l 
           \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
              PaO2
32
Q

Tidal volume setting calculation for ventilator cases

A

8-15ml/kg

33
Q

Minute volume calculation

A

Tidal Volume x Resp Rate

34
Q

Feline asthma has an increased effort on ______

A

exhalation (narrow bronch - hard to push past)

35
Q

Phase 3 of ARDS what happens?

A

Fibrosis of lungs

36
Q

Ventilator sensitivity refers to what?

When would you adjust?

A

How sensitive it is to picking up on a patient’s spont. breath

Don’t want it too sensitive or it will think mouth cleaning/PROM is a breath initiation

37
Q

Thoracic lavage fluid dosing

A

10-20ml/kg

38
Q

I:E ratio (ideal) and Inspiratory time

A

1:2, 1.2 seconds insp time

39
Q

Oxyhemoglobin diss. curve shift to the RIGHT causes what changes to Temp and pH

A

Gives O2 to the tissues (leaves Hgb)

  • Temp Rises
  • Low pH
40
Q

Phase 4 of ARDS what happens?

A

THEY DIE

41
Q

ALI vs ARDS criteria (PaO2/FiO2 ratio)

A

ALI <300

ARDS <200

42
Q

What concern do you have if you see beaking? What should you do?

A

Lung compliance is failing (lungs are stiffening - too much pressure)- turn down PIP

43
Q

PIP (inspiration press) should not exceed what?

A

20-25 cm H20 (just like giving a breath)

44
Q

Assist-control breaths

A

patient can start the breath but the machine ensures it’s a GOOD one

45
Q

End tidal in comparison to arterial

A

2-6mmhg LOWER than PaCO2

46
Q

Ventilator: two different control modes

A

Pressure

Volume

47
Q

NasoTRACHEAL measurement

A

thoracic inlet

48
Q

Nasal O2 rates

A

50-100ml/kg/min

Max 5-6L/min

49
Q

SpO2 of 98-100% correlates to what PaO2?

A

100-600mmhg

50
Q

A-a gradient interpretation

A

0-10 normal
11-20 questionable
21-30 O2 benefitial
>31 O2 indicated

51
Q

CPAP does what? Spontaneous or not?

A

keeps a PEEP - keeps the alveoli open

spontaneous

52
Q

Five Criteria for ARDS

AKIPI

A
  • acute
  • known risk factors
  • inflammation
  • pulmonary capillary leak
  • inefficient gas exchange
53
Q

What value should be changed in the A-a gradient calculation at different altitudes?
Example of Sea Level vs. Denver vs. Everest

A

Barometric pressure

  • Sea level is 760mmhg
  • Denver is 640 mmhg
  • Mount Everest is 247 mmhg
54
Q

Venous CO2 in comparison to arterial

A

Venous is typically 3-6mmhg HIGHER

55
Q

PaO2 should be approximately _____ times the FiO2

A

5 times
FiO2 is 21% –> PaO2 105

100% O2 –> PaO2 500

56
Q

Oxyhemoglobin diss. curve shift to the LEFT

A

Increased SaO2, tissues are LEFT behind

  • LOW temp
  • elevated pH