Special Procedures - B (Module) Flashcards
The pulmonary function technologist has obtained an arterial blood gas sample from a patient and is preparing the sample for storage and transport to the laboratory for analysis. The technologist has properly labeled and capped the sample syringe. The technologist should transport the sample in a/an
A. rigid air-tight container.
B. ice and water solution at 0°C.
C. plastic container at room temperature.
D. plastic biohazard bag.
B. ice and water solution at 0C.
Temperature is the key.
You want to transport an ABG in a ice and water solution at 0C to stop metabolism.
Diaphragmatic breathing training is utilized in pulmonary rehabilitation in order to
A. improve the efficiency of ventilation.
B. reduce tidal volume breathing.
C. encourage prolonged exhalation.
D. increase respiratory rate.
A. improve the efficiency of ventilation.
Using the diaphragm is more efficient because it burns less oxygen to ventilate well, versus using accessory muscles.
A patient with a 50 pack-year smoking history has a measured COHb level of 15%. The maximum oxygen saturation that could be calculated for this patient is
A. 75%.
B. 80%.
C. 85%.
D. 90%.
C. 85 %
If 15% of the total saturation is taken by CO Hb, there is only 85% left for oxygen saturation.
A patient is receiving 35% oxygen via aerosol mask. The barometric pressure is 760 torr and the arterial blood gas results are as follows:
pH 7.42
PaCO2 36 torr
PaO2 82 torr
HCO3- 23 mEq/L
What is the correct value for the patient’s PAO2?
A. 180 torr
B. 200 torr
C. 260 torr
D 320 torr
B. 200 torr
Alveolar Equation Shortcut:
(FiO2 x 7) - PaCO2
Which of the following is the correct value for cardiac output for a patient with the following laboratory results?
CaO2 16 vol%
CvO2 10 vol%
VO2 200 mL/min.
A. 1.9 L/min
B. 2.5 L/min
C. 3.4 L/min
D. 4.2 L/min
C. 3.4 L/min
Qt = Cardiac Output
VO2
_____
(a - v) x 10
remember the “magic 10”
*page D-18
Which of the following is/are considered long-term benefits of a pulmonary rehabilitation program?
- Increased resting and exercise heart rate
- Improved sputum clearance
- Reduction of severity of dyspnea
- Improved appetite
A. 2 and 4 only
B. 1 and 3 only
C. 2, 3 and 4 only
D. 1, 2, and 4 only
C. 2, 3, and 4 only
*page D-42
Listen to the audio explanation.
A patient’s calculated oxygen saturation from the blood gas analyzer is reported at 96% and the measured saturation is recorded at 90%. Which of the following can best explain the difference in the SaO2 levels?
A. Air entered the sample as it was being analyzed
B. Elevated COHb level in the patient’s blood
C. The electrode that calculated the saturation is out of calibration
D. An error occurred with the software that calculates the saturation level
B. Elevated COHb level in the patient’s blood.
Trick question…
“calculated” is not as accurate as measured.
If there is a difference between the “calculated” and measured saturation values, the difference may be elevated COHb, which will produce a high total saturation that is made up of CO and O2.
While reviewing test results on a patient in the pulmonary function lab, the blood gas report shows an O2 saturation of 97% while the multiple wavelength spectrophotometer reports an O2 saturation of 76%. The technologist should estimate the patient’s COHb level to be
A. 1 - 5%.
B. 5 - 10%.
C. 10 - 15%.
D. 18 - 22%.
D. 18 - 22%
A “multiple wavelength spectrophotometer” is a CO-oximeter, which measures COHb.
Total saturation (97%) minus O2 saturation from CO-oximetry (76%) is 21%, which makes D the correct answer.
A patient has the following test results: VE 9.0 L/min (BTPS), PaCO2 40 torr, PeCO2 24 torr and respiratory rate of 15 bpm. All of the following are true statements, EXCEPT
A. The tidal volume is 600 mL
B. The anatomic deadspace is 240 mL
C. The alveolar minute ventilation is 6.0 L/min
D. The VD/VT is 0.40
C. The alveolar minute ventilation is 6.0 L/min
If you do the Vd/Vt calculation, deadspace is 40% of your total Ve of 9.0, which means alveolar ventilation is not 6.0 L/min, it is 5.4 L/min. C is false.
With a Ve of 9.0 and an RR of 15, the Vt would be 600. A is true.
With a tidal volume of 600 and a deadspace of 40%, anatomic deadspace is 240 ml. B is true.
With a PaCO2 of 40 and a PeCO2 of 24, Vd/Vt is 0.4. D is true.
*listen to the audio for this one
A patient has the following arterial blood gas results:
pH 7.28 PaCO2 33 torr PaO2 90 torr HCO3- 13 mEq/L SaO2 94%
Which of the following is the correct interpretation of these results?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
B. Metabolic acidosis
ABG algorhythm:
Look at pH and CO2:
Is it an acidosis or alkalosis? 7.28 is an acidosis. Eliminate alkalosis answers.
Did CO2 cause it? No. So it’s Metabolic.
Eliminate respiratory answers.
The pulmonary function technologist prepares to perform spirometry testing on several patients in the pulmonary function laboratory today. The technologist needs to handle all of the equipment properly for multiple patients. Which of the following is the most appropriate method to disinfect the external spirometer tubing used by the patient during each testing session?
A. Dispose of all equipment after each test is performed.
B. Wipe the surfaces of the equipment with alcohol after each use.
C. Replace all external spirometer tubing and disinfect after each use.
D. Perform proper handwashing after each test is concluded.
C. Replace all external spirometer tubing and disinfect after each use.
The pulmonary function technologist has an order to complete a DLCO test on a 64-year-old patient. The pulmonologist would also like the technologist to calculate the patient’s arterial oxygen content value. Which of the following test results are necessary to perform this calculation?
A. Venous and arterial blood gases
B. FIO2 and PB
C. Pulse oximetry and ABG
D. CBC and ABG
D. CBC and ABG
The question is asking you to calculate arterial oxygen content. (CaO2)
CaO2 = Hb x 1.34 x SaO2
The CaO2 calculation requires: SaO2 (from ABG)
Hb (from CBC)
The only option that includes both is D.
A 59-year-old male patient with a history of diverticulosis has been admitted to the hospital with abdominal pain and vomiting for the last two days. Which of the following acid base situations should the pulmonary function technologist expect for a recently drawn arterial blood gas?
A. Metabolic acidosis
B. Mixed respiratory and metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
C. Metabolic alkalosis
“Vomiting” would remove gastric acids from your body, which would cause an alkalosis.
Metabolic alkalosis is the most common blood gas abnormality, because when a patient is sick, they’ll lose electrolytes, fluids (dropping potassium) and acids from vomiting.
A 47-year-old chicken farmer has been admitted to the emergency room with shortness of breath. The patient states that he was outside spreading fertilizer on his fields when he fell and accidently swallowed some of the fertilizer. His wife called 911 for transport to the hospital. Upon arrival of the patient in the Emergency Department, the physician ordered a blood gas and co-oximetry analysis. The pulmonary function technologist analyzing the laboratory results discovered that there is methemoglobinemia present. This is most likely caused by
A. trauma to the lung tissue.
B. pulmonary embolus.
C. anemia.
D. nitrate poisoning.
D. nitrate poisoning
Nitrates in fertilizer will affect Hb and prevent it from carrying oxygen.
Associate methemoglobin with nitrates.
The pulmonary function technologist would like to estimate a patient’s arterial oxygen saturation from the recorded blood gas values drawn on room air. Which of the following formulas can accomplish this?
A. Adding the PaCO2 and the PaO2 values together
B. Multiplying the patent’s FIO2 x 7
C. Adding 30 to the PaO2 value
D. Dividing the reported PaO2 value by 3
C. Adding 30 to the PaO2 value.
40, 50, 60 rule.
