Brainscape's Knowledge GenomeTM

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


See full index

Perf Monitoring > test 9 > Flashcards

test 9 Flashcards

1
Q

Our continued health depends on the body’s

ability

A

• To deliver the appropriate amount of oxygen to
each cell
• For each cell to uptake and consume the proper
amount of oxygen

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

Normal Oxygen Consumption

A

200-250 mL O2/min

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

What is the final common

pathway of all causes of death

A

tissue hypoxia

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

energy production is determined by what

A

metabolic rate

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

creation of energy is supported by what

A

adequate amounts of glucose and oxygen delivered to the cells

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

similarities between aerobic and anaerobic metabolism

A
  • both start with glucose metabolized to pyruvate

- both produce ATP

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

Aerobic metabolism

A

-O2 present
• Pyruvate converted to acetyl-CoA, which enters the Krebs cycle
which produces carbon dioxide, water and ATP
• 1 mole glucose→ 36 moles ATP
-end product= CO2 and H2O

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

Anaerobic metabolism

A

• Pyruvate converted to lactic acid and ATP
• 1 mole glucose→ 2 moles ATP
-end product= lactic acid

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

monitoring what can tell you a lot about what has occurred during your pump run

A

lactate

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

why measure lactic acid in blood

A

-if lactic acid present, we know that there are areas in our body where anaerobic metabolism has occurred

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

Arterial O2 content

A

17-20 mL/100mL blood

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

Venous O2 content

A

12-15 mL/100mL blood

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

A-V O2 difference

A

4-6 mL/100mL blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is one of the best ways to increase O2 content

A

-increase hemaglobin

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

O2 delivery (& normal value)

A
  • DO2 = Arterial content × Cardiac output
  • 950-1150 mL O2/min
  • Indexed: 550-650 mL O2/min/m2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

O2 reserve

A

• The amount of oxygen left AFTER consumption
has taken place
• Venous gases returning to the heart
• A built-in physiologic buffer (in case we need it)

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

Normal Oxygen Reserve

A
  • 700-800 mL O2/min

- Indexed: 450 mL O2/min/m2

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

How long can you use your reserve

A
  • around 32% SvO2

- then anaerobic metabolism starts to come into play

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

Factors That Increase Oxygen Consumption

A
  • Patient conditions
  • Medications
  • Procedures
20
Q

Patient Conditions that Increase Oxygen Consumption

A
  • Minor surgery: 7% increase
  • Fever (each 1 o C): 10%
  • Agitation: 16%
  • Increased work of breathing: 40%
  • Severe infection: 60%
  • Chest trauma: 60%
  • Shivering: 50 to 100%
  • Sepsis: 50 to 100%
21
Q

Medications that Increase Oxygen Consumption

A
  • sympathetic agonists

- causing an increase in CO and vasoconstriction

22
Q

Procedures that Increase Oxygen Consumption

A
  • Dressing change: 10% increase
  • Physical examination: 20%
  • Visitors: 22%
  • Endotracheal suctioning: 27%
  • Turning: 31%
  • Chest physiotherapy: 35%
  • Nasal intubation: 25 to 40%
23
Q

Factors that Decrease Oxygen Consumption

A
  • Hypothermia (7oC): 50% decrease
  • Morphine sulfate IV: 21%
  • Anesthesia: 25%
  • Assist/control ventilation: 30%
  • Neuromuscular blocking agents
24
Q

Ischemic hypoxia

A

• Inadequate blood flow (regional or general)
• Obstructive lesions of blood vessels
-(Coronary or cerebral thrombosis or spasm or Peripheral vascular disease)

25
Q

Hypoxemic hypoxia

A
  • Inadequate transfer of oxygen from the lungs to the hemoglobin molecule
  • Hypoxemia most common cause, Carbon monoxide poisoning, Methemoglobinemia
26
Q

Anemic hypoxia

A

-Deficiency of hemoglobin molecules

27
Q

Toxic hypoxia

A
  • Inability of body cells to uptake or use oxygen

- Sepsis, cyanide toxicity, and ethanol toxicity

28
Q

Excessive tissue requirements

A
  • Oxygen demand higher than system can supply

- Hypermetabolism, Sepsis, alcohol withdrawal, extreme fever

29
Q

Impaired oxygen unloading

A
  • At the capillary level

- alkalemia, hypocarbia, and Administration of large amounts of banked blood

30
Q

Compensatory Mechanisms for Impaired Tissue Oxygenation

A
  1. Increase cardiac output (primary response)
  2. Draw from venous reserve
  3. Polycythemia
31
Q

Increase cardiac output (primary response)

A

• The tissues control the cardiac output in accordance with their
need for oxygen
• Healthy heart can increase to 15-25 L/min
-acute response

32
Q

Draw from venous reserve

A

• Extract more oxygen from hemoglobin
• Can decrease venous sat to 32% before anaerobic metabolism starts
-acute response

33
Q

Polycythemia

A

• Increase amount of hemoglobin and RBC mass
• Takes weeks to develop
-long term response

34
Q

Monitoring Oxygen Transport

A
  • Arterial and mixed venous blood gas (central lab)
  • Point-of-care blood gas
  • Noninvasive pulse oximetry
  • Invasive mixed venous saturation
  • Continuous indwelling arterial blood gas
  • Transcutaneous measurement of local tissue saturation
35
Q

Arterial and Mixed Venous Blood Gases from Central Lab

A
  • Lag time between sampling and results
  • Intermittently performed
  • May not detect acute, severe hypoxemia
36
Q

Point-of-Care Blood Gas Analyzers

A

-bedside blood gas

37
Q

Point-of-Care Blood Gas Analyzers pros

A 
• Able to measure gases, electrolytes, glucose, lactate, urea, nitrogen
and hematocrit
• Small and portable
• Small blood volume required
• Self-calibrating
• Disposable cartridges
38
Q

Point-of-Care Blood Gas Analyzers cons

A

• Can be expensive with labor intensive quality control

39
Q

Noninvasive Pulse Oximetry

A

• 2 light emitting diodes (LED) send red and infrared
light through the arterial vascular bed
• Photodetector measures transmitted light and
detects the relative amount of color absorbed by
arterial blood and estimates the saturation
• Saturated Hb= Absorbs more infrared light
• Desaturated Hb= Absorbs more red light
-can be placed on the patient’s finger, toe, earlobe or nose bridge
• Accuracy: ± 4%
• less reliable with saturations between 50 and 70%
• no accuracy below 50%
• Adequate peripheral perfusion required

40
Q

Noninvasive pulse oximetry does NOT

A

-guarantee that oxygen is being delivered to or used by the cells

41
Q

Falsely ↓ Saturation Values for Pulse Oximetry

A
  • Nail polish/acrylic nails
  • Dark skin pigmentation
  • IV dyes
  • Lipid infusions
  • Anemia (Hct < 10%)
  • Venous pulses
  • Patient movement
42
Q

Falsely ↑ Saturation Values Pulse Oximetry

A
  • Elevated carboxyhemoglobin
  • Elevated methemoglobin
  • Intense surgical light
43
Q

SpO2 Ranges

A
  • 96-99% : Normal
  • 85-90% : Mild tissue hypoxia
  • 75-85% : Significant widespread tissue hypoxia
44
Q

Invasive Mixed Venous Saturation

A

• Measured via fiberoptic pulmonary artery
catheter
• Uses reflectance spectrophotometry

45
Q

Invasive Mixed Venous Saturation: General Info

A

• very fragile so you don’t want to break them or bend/kink
• Manufacturer specific pre-insertion calibration
required and in vivo calibration
• Keep catheter tip away from the wall of the
pulmonary artery (reflection from the vessel will distort results)
• Not able to distinguish carboxyhemoglobin and
methemoglobin from oxyhemoglobin

46
Q

Continuous Indwelling Arterial and Venous Gases

A
  • can measure saturation through tubing of pump
  • can take continuous blood gasses of samples
  • calibrate with tanks of gas
47
Q

Transcutaneous Measurement of Local Tissue Saturation

A
  • near-infrared spectrometry (NIRS)
    • Uses specific, calibrated wavelengths of nearinfrared
    light
    • light is absorbed relative to amount of oxygen attached
    to the hemoglobin in the blood vessels

Perf Monitoring (6 decks)

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