Respiratory Flashcards
Normal pH value
7.35-7.45
Normal pCO2 Value
35-45
Normal HCO3 Value
22-26
Normal pO2
80-100
Chest tube insertion site
4-5 ICS anterior axillary line
Early shock patient’s usually have what type of Acid-Base Imbalance
Respritory alkalosis
Due to increase in respirtory rate increase in early shock as the body attempts to compensate
Patient’s ABGs are pH7.43, pCO2 56, HCO3 34, what should you do to correct the pCO2?
analyze electroytes and replace the deficiency because the patient’s pH is normal indicating that they have compensated.
Electrical Alternans indicates what and how does it present?
Pericardial effusion
alterations in the QRS complex amplitude or axis between heart beats.
Signs and symptoms of Malignant hyperthermia
Increased EtCO2, temp, muscle rigidity
administration of succs, general anesthesia gas agents,
Medication for treatment of malignant hyperthermia
Dantrium/dantroline 2.5 mg/kg
Prefered site of needle thorocostomy
2nd ics, midlcavicular line
Hammons sign
Crunching sounds during heart sound asculation and my be synchronized with heart beat, associated with trachiobronical injury
Two vent settings that change effect the patient’s oxygenation
FiO2 and PEEP
Mintue Ventilation formula
Vt x RR=VE
Normal tidal volume for vent pt
5-8ml/kg of IBW
High limit of acceptable pPlat
35cm/h2o
test used to most often diagnose PE
VQ lung scan
Acute respiratory falure is define as (ABG values)
pO2 <60
pCO2 >50
Left Shift on the oxy-hemoglobin curve
Casues increase in the affinity, making oxygen easier for hemoglobin to pick up but harder to relase
remember the L for Left and Low
-LOW/holds on to oxygen
-LOW Temp
-LOW 2,3 DPG (production decreased with septic shock and hypophosphatemia
-LOW pCO2
-aLkaLosis (there is an L in alkalosis)
Right shift of the oxy-hemoglobin curve
Causes a decrese in the affinity of the hemoglobin to oxygen making it harder for hemoglobin to bind to oxygen.
R stands for raisted/relases oxygen
-Raised temp (hyperthermia)
-Raised 2,3 DPG
-Raised pCO2
-Acidosis, (there’s no L in Acidosis)
Repeated doses of Etomadate can cause
Acute adrenal Insufficiency
BNP is used to test for what
Heart failure,
It is an amino acid that is relased by the ventricles in response to excessive streatching of the heart muscle
Defaciculation dose of NMB is
10% of the RSI dosage used to prevent faciliculations in truama
Elevated Anion Gap is defined by what values and is associated with what acid base balance and why
Metobolic acidosis
AG=Na-(Cl+HCO3)
Normal value is 4-12
abnormal >16
Average ET tube for
adult male
adult female
8-9mmID
7-8mmID
Sedative indicated for bronchoconstriction
Ketamine
ARDS patient would require from what vent settings most
PEEP, ARDs lungs are typically irregularly inflamed and highly vulnerable to atelectasis, they have decreased compliance and increased deadspace.
Airways with inflamation and narrowed passages, hypoxemia stimulates hyperventilation with resultant decrease in PaO2
Asthma
Obstrucitve airflow disease, hypersecreastion of mucous preventing airflow to alveoli, hypoventilation resluting in hypercapnea and hypoxemia, VQ mismatch, pulmonary HTN and RV hypertrophy resluting in cor pulmonale
Chronic Bronchitis
Destruction on alveoli and loss of elascticity, decreased gas exchange, air trapping, decresed elastic recoil of the lungs, increased RBC and Hematacrit
Emphysema
COPD chest x ray finding
Hyperinflation of the lungs and narrow elongated heart shadow, flattened diaphram
ARDS chest flim fliding
Ground glass infiltrates
Sign for impending acute respiratory failure in the asthma patient
Absence of whezing, indicating the patient cannot ventilate sufficiently to produce breath sounds.
Define widened pulse pressures
And when is it seen
Pulse Pressure = Systolic Blood Pressure – Diastolic Blood Pressure
<40
Seen in Cushings triad (increased ICP) widened pulse pressures, irregular respirations, bradycardia.
Define narrow pulse pressures
Pulse Pressure = Systolic Blood Pressure – Diastolic Blood Pressure
Narrow pulse pressures occur in several diseases such as heart failure, blood loss, and cardiac tamponade.
Diarrheal dehydration can cause what acid base imbalance
metabolic acidosis, loss of hydrogen ion through the kidney or GI tract.
Vomiting or suctioning GI contents can cause what acid base imbalance
Metabolic alkalosis by the loss of gastic secreations which is rich in Hydrochloric acid
Diuretics use can cause what acid base imbalance
Metabloic alkalosis due to loss of hydrogen ion through the kidney
Hypoventilation or resp arrest caused what acid base imbalance
resp aciosis
hyperventilation causes what acid base imbalance
resp alkalosis
PIP should be less than what
40
Ideal body weight formula
IBW (kg) males=50 + 2.3 (height in inches – 60)
IBW (kg) females = 45.5 + 2.3 (height in inches – 60)
Pplat represents what and should be less than
measures alveolar pressure and should be less than 30
Where are the main chemoreceptors located?
Medulla and Pons
Would a pulmonary embolism increase or decrease the V/Q ratio?
Increase
