respiratory pathophysiology Flashcards
so if a patient pH < 7.35 , HCO3 > 28 , and PaCO2 is > 45 what is the correct acid/base interpretation
normal values:
pH 7.35-7.45
HCO3= 22-26
PaCO2= 35-45
well pH is acidosis bc less then 7.35 and if can only be acidic if PaCO2 is high or HCO3 is low
so respiratory acidosis with partial compensation from bicarb
is PaCO2 an acid or base
acid
is HCO3 an acid or base
base
someone with respiratory acidosis will have bradycardia or tachycardia
tachy
if you are having hyperventaliation will your pH go up or down
up
if a patient presents with pH > 7.45 , HCO3 < 24 , and PaCO2 < 35 what acid/base interpretation is this
normal values
pH= 7.35 -7.45
HCO3= 22-26
PaCO2= 35-45
pH is high so it is alkalosis / basic , HCO3 is normal and PaCO2 is low
so respiratory alkalosis with no compensation
if someone has excessive excretion of acids due to renal disease , loss of hydrochloric acid from prolonged vomiting and decreases plasma potassium levels which can lead to arrthymias what acid/base interpretation could they have
metabolic alkalosis bc decrease potasium levels and loss of hydrochloric acid
if a patient presents with pH > 7.45 , HCO3 > 28 and PaCO2 > 45 what acid/base interpretation is this
normal values
pH= 7.35-7.45
HCO3= 22-26
PaCO2= 35-45
pH is high so alkalosis , HCO3 is high so could be causing the alkalosis bc HCO3 is a base and PaCO2 is high so it could be compensating
so metabolic alkalosis with partial compensation
what acid/base interpretation can hyper kalemia lead to
metabolic acidosis
if a patient presents with pH < 7.35 , HCO3 < 22 and PaCO2 < 35 then what acid/base interpretation is it
norms
ph= 7.35 - 7.45
HCO3= 22-26
PaCO2= 35-45
pH is low so acidosis, bi carb is low and PaCO2 is low …. since bi car is low it is make it acid bc there is less base , is the PaCO2 was high then it would be respiratory
metabolic acidosis
if pH is low it indicates what ?
if high ?
low - acidosis
high - alkalosis
if CO2 is high and pH is low what does that indicate? is it hypoventilation or hyperventilation
respiratory acidosis (hypoventalation)
if CO2 is low and pH is high what acid/base interpretation does this indicate? hyperventilation or hypoventilation>
respiratory alkalosis (hyperventalation)
if HCO3 is high and pH is high what acid/base interpretation does this indicate
metabolic alkalosis
if HCO3 is low and pH is low what acid/base interpretation does this indicate
metabolic acidosis
patient 1: pH= 7.55 , CO2= 32 , HCO3= 20 what acid/base interpretation does this indicate
pH is high , CO2 is high ad HCO3 is low
so respiratory alkalosis with partial compensation
patient 2: pH= 7.47 , CO2= 61 , HCO3= 43 what acid/base interpretation does this indicate
pH is high , CO2 is high ad HCO3 is high
matabolic alkalosis with partial comp
patient 2: pH= 7.26 , CO2= 55 , HCO3= 24 what acid/base interpretation does this indicate
pH is low , CO2 is high ad HCO3 is normal
respiratory acidosis with no compensation
patient 2: pH= 7.32, CO2= 19 , HCO3=9 what acid/base interpretation does this indicate
pH is low , CO2 is low ad HCO3 is low
metabolic acidosis with partial compensation
if FEV1/ FVC is < 70% what disease can we suspect
obstructive for sure
what is decreased and what is increased in obstructive disorders
vital capacity, inspiratory reserve volum and expiration reserve volume is decreased
residual volume , total lung capacity , and functional residual volume is increased
what is the normal percent for forced vital capacity ? if it is over the normal what does that indicate and if it is under the norm what does that indicate
80%-120%
< 80% means restrictive lun disease
>120% means obstructive lung disease
what are the 2 main types of COPD
chronic bronchitis and emphysema
if somenoe has destruction of terminal bronchioles and alveolar wall and increase lung tissue compliance what disease do they most likely have
emphysema
if someone has excessive mucous production , airway narrowing and a productive cough on most days for the 3 months for 2 consecutive years what disease do they most likely have
chronic bronchitis
how will an emphysema patient present during exercise
develop oxygen desaturation
how will an chronic bronchitis patient present during exercise
oxygen saturation may decrease with exercise
someone will emphysema have ____ of the terminal airwyas
dilation
what type of emphysema affeects the alveoli which causes a loss of surface for air exchange and is predominately in the lower lobes
panacinar
what type of emphysema affects the respiratory bronchioles and is most commonly due to smoking and is primary in the upper lobes
centrilobular
patients with emphysema will present with __ chest deformity form hyperinflation and increased compliance (poor elastic recoil)
barrel
what is the key sign that a patient may have emphysema
FEV1 is < 80%
forced expiratory volume
at the end stages of emphysema ___ leads to pulmoanry artery hypertension which affects which side of the heart ?
hypoxemia (decreased O2 in the blood) and right side of the heart
there is going to be a ___ retention for patients with emphysema bc the right side of the heart is failing
Na (sodium)
what will be the difference on the xray finding with someone wiht emphysema
more ribs > 7
what is the reason to do purse lip breathing with pateints with COPD
it maintains intrabrinchial pressure and slows flow rate
if a pateint has excessive mucus production , cough with chronic sputum , cyanosis or polycythemia what disease may they have
chronic bronchitis
what does goblet and mucoid hyperplasia do
produces excessive mucus
someone with chronic bronchitis will have pulmonary hypertension whcih will lead to what ??
R ventricular failure and cause cor pulmonale , juglar vein distension and fluid retention
“blue bloater”
airway obstruction causes an ___ in resistance
increase
when breathing rapidly , __ pressure is needed to overcome the resistance to flow and the volume of each breath gets ___
greater
smaller
what is the causes of obstruction for asthma patient
reduced lumen of bronchi due to bronchospasm and increased bronchial wall thickness
what is a bronchospasm
smooth mm contraction of airways
if someone has an hyper inflated lungs what are 3 things that it can causes
air trapping
difficult breathing
reduced FEV1
pollen, animals , feather , mold and food are all what kind of triggers of asthma
extrinsic
what is bronchiectasis
dilation of the bronchial walls
what are the 3 types of bronchiectasis
cylindrical , varicose and saccular
what is restrictive disorders of the lung characterized by
reduction in vital capacity
what are the 5 things that are decreased with restrictive disorders
vital capacity
residual volume
functional residual capacity
tidal volume
total lung capacity
restrictive disorders can be pulmonary and is related to the lung themselves by what disease
pulmonary fibrosis
restrictive disorders can be extrapulmonary and is related to what
SCI
in RLD the compliance of the lung is ___, which increases the ___ of the lung and limits ____
reduced
stiffness
expansion
in RLD there is a ___ pressure required than normal to give the same increase in volume
greater
what are some acute pulmonary restrictive disorders
atelectasis
pneumothorax
pneumonias
acute respiratory distress syndrome
someone with kyphosis or scoliosis may have a hard time ___ the ribs
expanding
pleural effusion , abdominal ascites and intrathoracic surgical implants are examples of what lung disorder
restrictive
what is a partial collapse of lung parenchyma (alveoli)
atelectasis
what type of ateletasis is alveolar collapse , perhaps related to surface tension changes
microactelectasis
what are some signs that may be included with a patient with microactelectasis
reduced chest wall excursion
crackles
bronchical sounds (consolidation)
tracheal and mediastinal shift on xray
what are 2 disorders that can come after microactelectasis
respiratory distress syndrome
L ventricular failure
when does obstructive atelectasis happen
when bronchus is totally occluded
obstructive atelectasis is when air __ to the obstruction is re absorbed by the ___
distal
alveoli
obstructive actelectasis is usually associated with ___ shift towards the side of the lung collapse
tracheal
what is bronchial pneumonia usually caused by
staphlococcal or strep
what is lobar pneumonia usualt causes by
pneumococcus
what is the main difference with bronchial and lobar pneumonia
bronchial is little consoldiation and lobar is consolidation
what is the same with bronchial and lobar pneumonia
fever and SOB and coughing
which pneumonia produces large amaounts of sputum when they cough
bronchial
what will you see on xray for bronchial pneumonia
patchy infiltrates on xray
