Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Perf tech II > test 1 > Flashcards

test 1 Flashcards

1
Q

in a closed system, gas content

A
  • cannot change

- no gas fluid interface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

an increase in H+ concentration results in

A

-decrease in pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a decrease in temperature results in

A
  • increase in solubility
  • decrease in PPg
  • moves dissociation to the left
  • increase in pH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

pH of neutrality

A

-at specific temperatures there is a new pH of neutrality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Henry’s law

A

 Dissolved = Solubility x Partial Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Solubility of CO2 and O2

A

 CO2 @ 37 degrees C = 0.06 mls CO2
/100 mls bld/mmHg
 O2 @ 37 degrees C = 0.003 mls O2
/100 mls bld/mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CO2 moved from the lungs to tissue (3)

A

 Dissolved
 Bound to hemoglobin
 As HCO3- (majority of CO2)
-all three determine CO2 content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how to change the pH of blood in a closed system

A

1) Change total CO2 content – KEEP TEMP CONSTANT
2) Change temperature – keep total CO2 content constant
3) Change total CO2 content – change temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Option one: Increase total CO2 content by ADDING additional CO2

A

 pCO2 will increase

 pH will decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Option one: Decrease total CO2 content by REMOVING CO2

A

 pCO2 will decrease

 pH will increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Option two: Increase temperature

A

 Drive acid-base disassociation equilibrium to the right
 [H+] will increase
 pH will decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Option two: Decrease temperature

A

 Drive acid-base disassociation equilibrium to the left
 [H+] will decrease
 pH will increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Option three: Change total CO2 content and Change temperature

A

 pCO2 will change producing an inverse change in pH
 Disassociation equilibrium will change causing a
corresponding increase or decrease in [H+]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
Temperature Increases:
 Gas solubility \_\_\_\_\_\_\_\_\_\_\_\_\_
 Gas partial pressure \_\_\_\_\_\_\_\_\_\_\_\_\_
 Therefore gas pressure is \_\_\_\_\_\_\_\_\_\_\_\_\_ than the
starting gas pressure
 Equilibrium of the water dissociation shifts to the
\_\_\_\_\_\_\_\_\_\_\_\_\_
 Therefore, pH will \_\_\_\_\_\_\_\_\_\_\_\_\_
A

 Gas solubility decrease
 Gas partial pressure increase
 Therefore gas pressure is higher than the
starting gas pressure
 Equilibrium of the water dissociation shifts to the
right
 Therefore, pH will decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Draw sample

A

 Need: waste syringe, sample syringe, cup of ice (??)
 Draw from patient
 Draw from ECC
 Remove all air from sample – Cap tightly – Place in cup of ice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Blood Gas Determination Via Lab

A

 Blood from sample injected into analyzer
 Analyzer WARMS sample to 37o C
 Analyzer determines the pO2, pCO2, and pH at 37o C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

uncorrected gases

A

 Report gas values determined at 37oC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

corrected gases

A

 Report gas values measured at 37oC but corrected back to actual body temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Patient temp is 25o so analyzer will WARM the sample. pH, CO2, and O2 will be

A

 pH will be lower than expected (0.0147 per degree)
 CO2 will be higher than expected
 O2 will be higher than expected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

On bypass, you must look at the temperature corrected

blood gases to correctly treat the patient’s what

A

pO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

where does most of the acid-base buffering in the body happen

A

-in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

primary blood buffering system for maintaining a constant ratio of OH- to H+ (16:1) due to the changes in temp is

A
  • Imidazole moiety of the amino acid histidine

- found on most blood born proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is controled by alpha stat and pH stat management of blood gases

A
  • pH and pCO2

- arterial pO2 MUST be temperature corrected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how do you increase pCO2

A

increase CO2 content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

In a normal human, what stays constant

A

CO2 content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

intracellular pH (7.0)

A
  • much lower than the blood pH

- more water inside the cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

as temperature increases, what happens to pH

A

pH decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

pH varies from organ to organ. Why?

A

-temperature of each organ is different therefore changing the pH form organ to organ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Advantages of keeping CO2 content constant

A

 Maintains constant pH difference across cell membranes
 Maintains constant ratio of negative to positive charges on proteins
 Allows enzyme systems to work at optimal level regardless of temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what stays constant and what changes for pH stat

A
  • constant- pH

- changes- temperature CO2 content

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what stays constant and what changes for alpha stat

A
  • constant- CO2 content

- changes- temperature and pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

consequences of hypothermia for pH stat

A

 blood more acidic (b/c of increase in CO2 content)
 hydrogen ion gradient across the cell membrane changes
 acidity alters metabolic activity (metabolic rate goes down)
 cells do not maintain electroneutrality
 added CO2
influences blood flow regulation (increase CO2> increase vasodilation)

33
Q

consequences of hypothermia for alpha stat

A

 maintain constant charge on alpha-imidazole side chain
 hydrogen ion gradient across cell does not change
 cellular enzyme functions are maintained
 cells maintain electroneutrality
 auto-regulation of blood flow maintained (flow depends on metabolism)

34
Q

alpha-stat for peripheral perfusion

A

-studies suggest improvement of peripheral

perfusion

35
Q

alpha stat cerebral blood flow

A

-less than normal because it is based on metabolic need of tissue

36
Q

pH stat cerebral blood flow and management

A
  • greater than normal because pressure dependent
  • go from metabolism controlling CBF to a change in pressure controlling CBF
  • lose autoregulation
37
Q

Cerebral blood flow normally autoregulated

A

 flow tightly coupled to cerebral metabolism
 flow independent of blood pressure
 flow regulated by PCO2

38
Q

luxury flow

A
  • flow is greater than the metabolic rate

- as blood flow through a tissue goes up, potential for embolic injury goes up

39
Q

lose autoregulation at what temp

A

20 decrees C

40
Q

pH-stat uncouples flow and metabolism

A

 greater blood flow – pressure dependent
 improved cooling – more homogeneous
 luxury flow – predispose to risk of embolic injury, high intracranial pressure, edema

41
Q

Alpha-stat maintains autoregulation

A

 lower blood flow – based on metabolism

 predispose to adverse distribution of blood flow – risk of ischemic injury

42
Q

kids are more susceptible to

A

-ischemic injury rather than embolic injury

43
Q

adults more susceptible to

A

-embolic injury rather than ischemic injury

44
Q

regular bypass adult strategy

A

 With little or no hypothermia might not make any difference.
-With mild to moderate alpha-stat might be better

45
Q

PROFOUND WITH ARREST ADULTS best strategy

A

 Combination (cross-over) best approach – use pH stat while cooling to ensure maximal cerebral metabolic suppression – switch to alpha-stat to remove acidosis

46
Q

INFANTS best strategy

A

 Appears pH-stat may offer better outcomes (major cause of brain injury may relate more to hypoperfusion rather than emboli (might switch to alpha stat)

47
Q

manage pH stat

A
  • Always keep temperature corrected PCO2 at 40 mmHg

* Always keep temperature corrected pH at 7.40

48
Q

You are on bypass and the patient is at 28o. Your last blood gas came back with the following temperature corrected values: PO2=98 mmHg; PCO2=30 mmHg; pH=7.53; bicarb=24; SvO2=74. Assuming you are practicing pH stat, which of the following best describes the patient’s total CO2
ontent?

A

Total CO2 content lower than it should be

49
Q

You are on bypass and the patient is at 28o. Your last blood gas came back with the following temperature corrected values: PO2=98 mmHg; PCO2=30 mmHg; pH=7.53; bicarb=24; SvO2=74. Assuming you are practicing pH stat, how would you bring the CO2 content back to where it should be?

A

Add CO2 to the patient

50
Q

You are on bypass and the patient is at 28o. Your last blood gas came back with the following temperature corrected values: PO2=98 mmHg; PCO2=30 mmHg; pH=7.53; bicarb=24; SvO2=74. Which of the following best describes how you would “fix” the PO2? [pH stat]

A

Increase FiO2

51
Q

You are on bypass and the patient is at 28o. Your last blood gas came back with the following temperature corrected values: PO2=98 mmHg; PCO2=30 mmHg; pH=7.53; bicarb=24; SvO2=74. Which of the following best describes how you would “fix” the SvO2? [pH stat]

A

Make no change

52
Q

You are on bypass and the patient is at 32o. Your last blood gas came back with the following temperature corrected values: PO2=350 mmHg; PCO2=60 mmHg; pH=7.15; bicarb=20; SvO2=60. Assuming you are practicing pH stat, which of the following best describes the patient’s total CO2 content?

A

Total CO2 content higher than it should be

53
Q

You are on bypass and the patient is at 320. Your last blood gas came back with the following temperature corrected values: PO2=350 mmHg; PCO2=60 mmHg; pH=7.15; bicarb=20; SvO2=60. Assuming you are practicing pH stat, how would you bring the CO2 content back to where it should be?

A

Remove CO2 from the patient

54
Q

You are on bypass and the patient is at 320. Your last blood gas came back with the following temperature corrected values: PO2=350 mmHg; PCO2=60 mmHg; pH=7.15; bicarb=20; SvO2=60. Which of the following best describes how you would “fix” the PO2? [pH stat]

A

Decrease FiO2

55
Q

You are on bypass and the patient is at 320. Your last blood gas came back with the following temperature corrected values: PO2=350 mmHg; PCO2=60 mmHg; pH=7.15; bicarb=20; SvO2=60. Which of the following best describes how you would “fix” the PCO2? [pH stat]

A

Increase gas-to-blood flow ratio

56
Q

You are on bypass and the patient is at 320. Your last blood gas came back with the following temperature corrected values: PO2=350 mmHg; PCO2=60 mmHg; pH=7.15; bicarb=20; SvO2=60. Which of the following best describes how you would “fix” the bicarb? [pH stat]

A

Add bicarb

57
Q

You are on bypass and the patient is at 320. Your last blood gas came back with the following temperature corrected values: PO2=350 mmHg; PCO2=60 mmHg; pH=7.15; bicarb=20; SvO2=60. Which of the following best describes how you would “fix” the SvO2? [pH stat]

A

Increase cardiac index

58
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which PO2 value do you use for your analysis?

A

91 mmHg

59
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which PCO2 value do you use for your analysis?

A

40 mmHg

60
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which pH value do you use for your analysis?

A

7.40

61
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which of the following best describes the patient’s total CO2 content?

A

Total CO2 content where it should be

62
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which of the following best describes how you would “fix” the PO2?

A

Increase FiO2

63
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which of the following best describes how you would “fix” the PCO2?

A

Make no change

64
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using alpha stat. Which of the following best describes how you would “fix” the pH?

A

Make no change

65
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using pH stat. Which PO2 value do you use for your analysis?

A

91 mmHg

66
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using pH stat. Which PCO2 value do you use for your analysis?

A

29.4 mmHg

67
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using pH stat. Which pH value do you use for your analysis?

A

7.51

68
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using pH stat. Which of the following best describes how you would “fix” the PO2?

A

Increase FiO2

69
Q

You are on bypass at 300. You have just received the following blood gas results:
PO2 [@ 37 = 100; @ 30 = 91]
PCO2 [@ 37 = 40; @ 30 = 29.4]
pH [@ 37 = 7.40; @ 30 = 7.51]
You are using pH stat. Which of the following best describes how you would “fix” the PCO2?

A

Decrease gas-to-blood flow ratio

70
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using pH stat. Which of the following values will you use for your PCO2 analysis?

A

55 mmHg

71
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using pH stat. Which of the following best describes how you would “fix” the PO2?

A

Make no change

72
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using pH stat. Which of the following best describes how you would “fix” the PCO2?

A

Increase gas-to-blood flow ratio

73
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using pH stat. Which of the following best describes how you would “fix” the SvO2?

A

Increase cardiac index

74
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using alpha stat. Which of the following values will you use for your PCO2 analysis?

A

75 mmHg

75
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using alpha stat. Which of the following best describes how you would “fix” the PO2?

A

Make no change

76
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using alpha stat. Which of the following best describes how you would “fix” the PCO2?

A

Increase gas-to-blood flow ratio

77
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 75; @ 25 = 55]
pH [@ 37 = 7.13; @ 25 = 7.23]
SvO2 = 65%
You are using alpha stat. Which of the following best describes how you would “fix” the SvO2?

A

Increase cardiac index

78
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 67.6; @ 25 = 40]
pH [@ 37 = 7.22; @ 25 = 7.40]
SvO2 = 84%
You used pH-stat to cool the patient. You now want to convert to alpha-stat. Which of the following best describes how you would adjust the pO2?

A

Make no change

79
Q

You are on bypass at 250. You have just received the following blood gas results:
PO2 [@ 37 = 275; @ 25 = 250]
PCO2 [@ 37 = 67.6; @ 25 = 40]
pH [@ 37 = 7.22; @ 25 = 7.40]
SvO2 = 84%
You used pH-stat to cool the patient. You now want to convert to alpha-stat. Which of the following best describes how you would adjust the pCO2?

A

Increase gas-to-blood flow ratio

Perf tech II (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions