Respiratory

Question 1

Alveolar ventilation calculation

Answer 1

TV x 0.35 x RR

Question 2

Pressure control - what is variable?

What type of dz process to be used in?

Answer 2

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

Question 3

Cyanosis does not appear until PaO2 is what?

Answer 3

50 or less

Question 4

Normal minute volume

Answer 4

150-250ml/kg/min

Question 5

Is CO2 or O2 more soluble?

Answer 5

CO2 is 20x more soluble than O2

Question 6

Patient on 100% O2 should have PaO2 of what?

Answer 6

300-500mmhg (99-100% SpO2)

Question 7

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

Answer 7

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

Question 8

PaO2 = what? (small a)

Answer 8

aterial

Question 9

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

Answer 9

Type I - exchange gas
Type 2 - produce surfactant

Causes edema

Question 10

Spo2 of 90-91% correlates to what PaO2?

Answer 10

60mmhg

Question 11

Setting PIP alarms is super important during what mode?

Answer 11

VOLUME control - don’t blow the patient up

Question 12

Higher levels of PEEP can lead to what?

Answer 12

decreased cardiac output

Question 13

PA02 = what? (big A)

Answer 13

Alveolar

Question 14

What is TRALI and when does it occur?

Answer 14

Transfusion related ALI

6 hours post transfusion

Question 15

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

Answer 15

Normal 40 mmhg
30 needs O2
20 emergent

Question 16

A-a gradient - 0-10 is what?

Answer 16

normal

Question 17

SaO2 = what?

Answer 17

Saturation of O2 on Hemaglobin

Question 18

Mandatory vs spontaneous breaths

Answer 18

Mandatory - machine controlled

Spontaneous - patient controlled

Question 19

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

Answer 19

Good for weaning

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

any machine initiated are full breaths

Question 20

• Decreased pleural space
• ETT obstruction
• Excessive dead space

Can all lead to what change in CO2?

Answer 20

ELEVATED

CO2

Question 21

Normal PaO2/FiO2 RATIO

Answer 21

476

100/0.21

Question 22

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

Where should the opening be?

Answer 22

75%

Top 1/4

Question 23

Volume control - what is fixed and what is variable?

Answer 23

Tidal volume is fixed

Pressure becomes variable

Question 24

ARDS acts like ____________, only in the lungs

Answer 24

sepsis - leaky vessels, hyperinflammation

Question 25

A-a gradient >31 means what

Answer 25

O2 warranted

Question 26

Aspiration pneumonia typically doesn't show up radiographically until ___________

Answer 26

12-36 hours post aspiration

Question 27

ARDS mortality rate in vet med

Answer 27

90-100% | yikes

Question 28

Spo2 of 95-96% correlates to what PaO2?

Answer 28

80mmhg

Question 29

Approx what % of minute volume is DEAD space?

Answer 29

35%

Question 30

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

Answer 30

Breathe off that CO2 - Increase Rate - Increase Volume - Decrease PEEP

Question 31

oxyhemoglobin disc curve | what is on what axis>?

Answer 31

``` Sao2 l l l l _________________________ PaO2 ```

Question 32

Tidal volume setting calculation for ventilator cases

Answer 32

8-15ml/kg

Question 33

Minute volume calculation

Answer 33

Tidal Volume x Resp Rate

Question 34

Feline asthma has an increased effort on ______

Answer 34

exhalation (narrow bronch - hard to push past)

Question 35

Phase 3 of ARDS what happens?

Answer 35

Fibrosis of lungs

Question 36

Ventilator sensitivity refers to what? | When would you adjust?

Answer 36

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

Question 37

Thoracic lavage fluid dosing

Answer 37

10-20ml/kg

Question 38

I:E ratio (ideal) and Inspiratory time

Answer 38

1:2, 1.2 seconds insp time

Question 39

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

Answer 39

Gives O2 to the tissues (leaves Hgb) - Temp Rises - Low pH

Question 40

Phase 4 of ARDS what happens?

Answer 40

THEY DIE

Question 41

ALI vs ARDS criteria (PaO2/FiO2 ratio)

Answer 41

ALI <300 ARDS <200

Question 42

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

Answer 42

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

Question 43

PIP (inspiration press) should not exceed what?

Answer 43

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

Question 44

Assist-control breaths

Answer 44

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

Question 45

End tidal in comparison to arterial

Answer 45

2-6mmhg LOWER than PaCO2

Question 46

Ventilator: two different control modes

Answer 46

Pressure | Volume

Question 47

NasoTRACHEAL measurement

Answer 47

thoracic inlet

Question 48

Nasal O2 rates

Answer 48

50-100ml/kg/min | Max 5-6L/min

Question 49

SpO2 of 98-100% correlates to what PaO2?

Answer 49

100-600mmhg

Question 50

A-a gradient interpretation

Answer 50

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

Question 51

CPAP does what? Spontaneous or not?

Answer 51

keeps a PEEP - keeps the alveoli open | spontaneous

Question 52

Five Criteria for ARDS | AKIPI

Answer 52

- acute - known risk factors - inflammation - pulmonary capillary leak - inefficient gas exchange

Question 53

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

Answer 53

Barometric pressure - Sea level is 760mmhg - Denver is 640 mmhg - Mount Everest is 247 mmhg

Question 54

Venous CO2 in comparison to arterial

Answer 54

Venous is typically 3-6mmhg HIGHER

Question 55

PaO2 should be approximately _____ times the FiO2

Answer 55

5 times FiO2 is 21% --> PaO2 105 100% O2 --> PaO2 500

Question 56

Oxyhemoglobin diss. curve shift to the LEFT

Answer 56

Increased SaO2, tissues are LEFT behind - LOW temp - elevated pH