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Complex > Respiratory 2 > Flashcards

Respiratory 2 Flashcards

1
Q

ABG’s if respiratory acidosis

A

pH < 7.35, pCO2 > 45, HCO3> 26 if compensating

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2
Q

causes of respiratory acidosis

A

CNS depression from drugs
Respiratory arrest
Hypoventilation from pulmonary, cardiac or neuromuscular disease

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3
Q

signs of respiratory acidosis

A

Tachycardia, tachypnea early, then bradypnea, confusion, hypotension, lethargy, coma

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4
Q

ABG’s if respiratory alkalosis

A

pH > 7.45, pCO2< 35, HCO3 <22 if compensating

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5
Q

causes of respiratory alkalosis

A

Hyperventilation from anxiety, pain or vent settings
Respiratory stimulation by drugs, disease, fever
Gram-negative bacteremia
Pulmonary emboli

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6
Q

signs of respiratory alkalosis

A

Confusion, light-headedness, anxiety, palpitations, paresthesias

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7
Q

metablic alkalosis if…

A

vomiting/diarrhea/ GI fistulas

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8
Q

metabolic acidosis if…

A

DKA and renal failure
cannot excrete hydrogen ions (renal): acidodic
are not exchanging glucose, slows down NaK pump… hold on to acid (DKA): acidodic

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9
Q

how do you know if respiratory or metabolic problem??

A

If respiratory then pO2 is affected, not so in metabolic

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10
Q

how do you know if compensating or not

A

Compensated if pH is normal! Uncompensated if pH is not normal

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11
Q

describe emphysema

A
  • Fibrous type lungs filled with CT (grown d/t emphysema)
  • Decrease in lastase (lung become fibrotic)
  • Process of making fibrous tissue: continuous inflammatory process (chronic)
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12
Q

causes of emphysema

A
  • smoking, inhaled particles, vaping, black lung disease, smoke/smog
  • cannot get CO2 out of lungs
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13
Q

describe COPD

A
  • do not have good expansion (appears like a barrel chested, dead lung)
  • x ray is too dark/black, should see some lighting
  • AP diameter is too wide
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14
Q

what does pneumonia x ray look like

A
  • big old junk

- bacteria in the lungs, full of protein: pulls more fluid into lungs

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15
Q

what does pulmonary edema x ray look like

A
  • Whispy, fills up with fluid until lungs collapse
  • not a lot of room for oxygenation
  • air movement does not really occur/stuck
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16
Q

what is a VQ test

A
  • measure their ventilation vs perfusion
  • mismatch??
  • detect PE, evaluate pulmonary function
17
Q

describe the ventilation part of the VQ test

A

patient inhales a gas

see ventilation patterns

18
Q

describe the perfusion (Q) part of the VQ test

A

contrast medium is injected and blood flow is visualized

19
Q

what can interfere with a pulse ox reading

A
  • Elevated bilirubin level may falsely lower readings
  • IV lipids and dyes can interfere
  • Excessive light, movement, ear pigment, hypothermia, hypotension and vasoconstriction
  • Blue, green, black and brown nailpolish
20
Q

what can falsely elevate a pulse ox reading

A
  • Carboxyhemoglobin can falsely elevate readings

- anemic (d/t low RBC)

21
Q

what is a normal SVO2

A

60-80%

22
Q

what does a decreased SVO2 mean

A

decreased values, less than 60% may indicate increased oxygen usage by tissues or a decreased oxygen delivery

23
Q

what does an increased SVO2 mean

A

SVO2 values greater than 80% may indicate tissue death in organs, as they do not pick up the oxygen

24
Q

how is SVO2 measured

A

measured by a pulmonary artery catheter or a central line

*can also get off the ventilator

25
Q

a low (ie/ 50%) SVO2 may indicated what

A

means something is overworking (ie/ GI tract) or septic (distributive shock problem) or NOT picking up oxygen that it needs to begin with (then PO2 will be low AS WELL)

26
Q

what does SVO2 mean

A

how much oxygen is in our venous system?
should have dropped off oxygen by about 20%
delivering oxygen to organs

27
Q

what is the ETCO2

A

is used to measure the CO2 concentration at the end of expiration

28
Q

what is a normal ETCO2

A

normal if 30-40 (only about 2-5 different from CO2)

29
Q

what does the end tidal CO2 monitor

A

Monitoring patency of the airway in apnea and airway obstruction
Monitor hyperventilation or hypercapnia with ventilator systems

30
Q

what does a low ETCO2 mean (ie/ 10)

A

not breathing deeply enough to push off CO2

31
Q

what are the Beta 2 agonists (bronchodilators)

A

Albuterol and Epi

32
Q

what are the anticholinergics (bronchodilators)

A

Ipatropium and Tiotropium

Complex (38 decks)

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