Brainscape's Knowledge GenomeTM

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


See full index

Cardio pulm exam 2 > Tests & Lab Values > Flashcards

Tests & Lab Values Flashcards

1
Q

SpO2/SaO2:

A

norms = 95-100%

Below 88-90% usually requires supplemental O2

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

PaO2:

A

norms = 75-100 mmHg

> 100 mmHg = hyperoxygenation

<80 mmHg = hypoxygenation

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

PaCO2:

A

norms = 35-45 mmHg

> 45 mmHg = COPD, hypoventilation

<35 mmHg = hyperventilation, pregnancy, PE & anxiety

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

Blood pH:

A

norms = 7.35-7.45

<7.35 = acidic; respiratory acidosis = hypoventilation or metabolic acidosis: CO2 retainer

> 7.45 = basic; respiratory alkalosis= hyperventilation or metabolic alkalosis: vomiting, diuretics; low CO2

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

Type of coagulation tests =

A

prothrombin time (PT) = evaluates ability to clot

International Normalized Ratio (INR) = ensures that results from PT tests are the same from one lab to another

Partial thromboplastin time (PTT) = determines if blood-thinning therapy is effective

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

Prothrombin Time (PT):

A

norms = 11-15 sec

> 15 sec = clotting deficiency, hemorrhagic ds, cirrhosis, medication (warfarin)

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

Partial Thromboplastin Time (PTT):

A

norms = 25-40 sec

> 40 sec = see above

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

International Normalized Ratio(INR):

A

norms = 0.9-1.1

Look for signs of bleeding

Use compensatory strategies to reduce risk of falls or injury

Patients with DVT, PE, mechanical valve, AF = on anticoagulation therapy will have target INF 2-3; higher if genetic clotting condition INF 3.5

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

C-reactive protein (CRP):

A

norm = <10 mg/L

> 10 mg/L = platelet disorder, increase risk of atherosclerosis

> 100 mg/L = associated with inflammation & infection

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

White Blood Cells (WBC):

A

norms = 4,300-10,800 cells/mm3

Indicative of immune system status

> 10,800 = infection, inflammation, cancer, corticosterioids

<4,300 = aplastic anemia, folate deficiency; increased risk of infection

Wear mask when working with immunosuppressed patients

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

Red Blood Cells (RBC):

A

Male: 4.6-6.2 106/uL
Female: 4.2-5.9 106/uL

Increased levels = polycythemia; fatigue with activity

Decreased levels = anemia; Fatigue with activity

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

Hematocrit (Hct):

A

% by volume of RBC in whole blood

Male: 45-52%

Female: 37-48%

Increased levels = polycythemia, dehydration, shock

Decreased levels = severe anemia, acute hemorrhage

Decreased exercise tolerance, increased fatigue, and tachycardia

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

Hemoglobin (Hgb):

A

oxygen carrying protein

Male: 13-18 g/dL

Female: 12-16 g/dL

Increased levels = polycythemia, dehydration, shock

Decreased levels = anemia, hemorrhage, cancer, sickle cell disease

Decreased exercise tolerance, increased fatigue, and tachycardia

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

Platelet Count:

A

150,000-450,000 cells/mm3

Increased = chronic leukemia

Decreased = acute leukemia, anemia

Look for active signs of bleeding hematuria, petechiae

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

Platelet count and exercise guidelines:

A

<20,000: AROM, ADLs only

20,000-30,000: light exercise only

30,000-50,000: moderate exercise

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

Heart rate norms:

A

infants = 120 bpm

adults = 60-100bmp

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

BP norms:

A

infants = 75/50 mmHg

adults = <120/80 mmHg

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

RR norms:

A

infants = 40 br/min

adults = 12-20 br/min

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

PaO2 (ABG) norms:

A

infants = 75-80 mmHg

adults = 75-100 mmHg

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

PaCO2 (ABG) norms:

A

infants = 34-54 mmHg

adults = 34-45 mmHg

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

pH (ABG) norms:

A

infants = 7.26-7.41

adults = 7.35-7.45

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

Tidal volume norms =

A

infants = 20mL

adults = 500mL

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

Temperature norms =

A

infants = 97.9F

adults = 98.6 F (37C)

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

What is respiration?

A

Respiration: gas exchange across the alveolar-capillary and capillary-tissue interface

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

What is respiration measured by?

A

Arterial Blood Gases (ABG)

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

What is O2 saturation?

A

SpO2 or SaO2

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

What is the Ventilation/Perfusion ratio (V/Q match)?

A

Norm 0.7 - 0.8

< 0.7 = poor ventilation
> 0.8 = poor perfusion

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

What is diffusion?

A

movement of solutes from area of higher to area of lower concentration

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

What is ventilation?

A

(Ve) the physical act of moving gas, primarily oxygen (O2) and carbon dioxide (CO2), into and out of the lungs

Ve= Tidal Volume (Vt) normal breathing at rest x Respiratory Rate (RR)

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

Ventilation Normal adult values
(Ve, Vt, RR):

A

Ve: 6.0 –10.0 L/min at rest

Vt: 400 –850 ml per breath or .40 - .85 L/breath

RR: 12 – 20 breaths per minute (bpm)

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

What is FiO2?

A

Fraction of inspired oxygen

The % of oxygen at each inspired breath

32
Q

What is the FiO2of atmospheric room air?

A

21%

33
Q

What is respiratory failure?

A

Etiology: Inadequate gas exchange by the pulmonary system

initiated by critical drop in blood oxygen level (hypoxemia) and/or a rise in arterial carbon dioxide (hypercapnia)

PaO2<60mmHg or PaCO2 >50mmHg

34
Q

What is arterial blood gas (ABG)?

A

Blood sample taken from an artery = Invasive

Analysis assesses a patient’s partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2)

Provides information about the patient’s oxygenation status and ventilation status

Hyperventilation (low CO2) and hypoventilation (high CO2) affect blood gas = resulting in a change in pH status of the blood

35
Q

Pulmonary Assessment: Arterial Blood Gases

A

Assessment of the lungs ability to oxygenate the blood and remove carbon dioxide

assessment of problems related to acid-base balance, ventilation and oxygenation

Measures the pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery

The analysis of the partial pressure of gases within the arterial blood indicates the effectiveness of alveolar ventilation

36
Q

CO2 levels =

A

High CO2 = acidic
Low CO2 = alkaline

37
Q

What is ABG: Partial Pressure?

A

dynamic that explains why oxygen moves from the alveoli (oxygenated blood) into the capillaries (deoxygenated blood) and why carbon dioxide moves from the blood into the alveoli

Normal Dynamics: Partial pressure of oxygen is higher in the alveoli than the adjacent capillaries, it flows into the capillaries

since the partial pressure of carbon dioxide is higher in the capillaries than the alveoli, it moves from the capillaries into the alveoli

38
Q

Invasive Assessment of ABG =

A
  1. The blood pH: norm 7.35-7.45
  2. Partial Pressure of Carbon dioxide (PaCO2): Norm 35 – 45 mm Hg
  3. Partial Pressure of Oxygen (PaO2): Norm 75 – 100 mm Hg
  4. Amount of serum bicarbonate (HCO3): Norm 22 – 26 mmol/L
39
Q

Non-Invasive Assessment of ABG =

A

Oxygen Saturation (SpO2): Norm 94 – 100%

40
Q

Normal ABG values:

A

pH = 7.35-7.45
PaCO2 = 35-45
HCO3 = 22-26
PaO2 =80-100
SaO2 = 94-100

41
Q

what does low pH lead to?

A

acidemia

high PCO2 -= respiratory acidosis

OR

low HCO3 = metabolic acidosis

42
Q

what does high pH lead to?

A

alkalemia

low PCO2 -= respiratory alkalosis

OR

high HCO3 = metabolic alkalosis

43
Q

Pulmonary Assessment: Respiratory Alkalosis vs Acidosis

Order of values to look at:

A

pH first

PaCO2 is the next value to be determined - Compare the PaCO2 direction of the change with the direction of the change in pH

44
Q

what is the Inverse relationship between PaCO2 and pH:

A

PaC02 decreases (less than 35mmHg) & pH increases (>7.45) - Respiratory Alkalosis

PaC02 increases (more than 45mmHg) & pH decreases (<7.35) - Respiratory Acidosis

45
Q

Direct relationship between bicarbonate and pH: metabolic

A

increase bicarbonate, increase pH

decrease bicarbonate, decrease pH

Normal range is 22 to 26 millimoles per liter (mmol/L)

46
Q

When the direct relationship is evident, the primary cause of the altered pH is of a ___ etiology

A

metabolic

47
Q

What is Metabolic acidosis?

A

HCO3 <24 mmol/L

pH = decrease
PaCO2 = WNL
HCO3 = decreae

causes: Diabetic, diarrhea

signs/symptoms: Nausea, lethargy, secondary hyperventilation, coma

48
Q

What is Metabolic alkalosis?

A

HCO3 >24 mmol/L

pH = increase
PaCO2 = WNL
HCO3 = increaes

causes: HCO3 ingestion, vomiting, diuretics

signs/symptoms: Weakness, mental dullness

49
Q

What is respiratory alkalosis?

A

pH = increase
PaCO2 = decrease
HCO3 = WNL

causes: hyperventilation

signs/symptoms: dizziness, syncope

50
Q

What is respiratory acidosis?

A

pH = decrease
PaCO2 = increase
HCO3 = WNL

causes: hypoventilation

signs/symptoms:
Early: anxiety, restlessness, dyspnea, headache

Late: confusion, somnolence, coma

51
Q

What do you do to detect respiratory conditions:

A

First: examine pH value; if HIGH (above 7.45), ALKALOSIS is present

THEN: examine CO2 LEVELS, If below 35 mmHg, RESPIRATORY ALKALOSIS present

IF: pH was low (below 7.35) and CO2 levels are High (above 45 mm Hg),

RESPIRATORY ACIDOSIS is present

52
Q

What do you do to detect metabolic conditions:

A

FIRST: examine pH values——High pH (above 7.45)

SECOND: examine CO2 levels (assumed to be normal)

THIRD: examine bicarb levels—–high bicarbonate (above 24 mmol/L)

Condition: METABOLIC ALKALOSIS

53
Q

What is chronic respiratory acidosis?

A

pH <7.35
CO2 retention
PaCO2 >45 mmHg
HCO3 >28 mmol/L (compensating)

54
Q

What are the possible causes of chronic respiratory acidosis?

A

hypoventilation due to pulmonary, cardiac, musculoskeletal, or neuromuscular disease

CNS depression from medication = possibly slows RR and tidal volume

55
Q

What is chronic respiratory alkalosis?

A

pH >7.45
Excess CO2 excretion
PaCO2 <35 mmHg
HCO3 <24 mmol/L (compensating)

56
Q

What are the possible causes of chronic respiratory alkalosis?

A

hyperventilation due to anxiety, pain, or improper ventilator settings

respiratory stimulation caused by drugs, disease, hypoxia, fever, or high room temperature

57
Q

Metabolic acidosis findings:

A

pH <7.35
PaCO2 = 35mmHg
HCO3 <24 mmol/L

58
Q

Metabolic acidosis possible causes:

A

HCO3 depletion due to renal disease, diarrhea, or small-bowel fistulas

hepatic disease results in excessive production of organic acids

endocrine disorders = diabetes mellitus

59
Q

Metabolic alkalosis findings:

A

pH >7.45
PaCO2 = 45mmHg
HCO3 >28 mmol/L

60
Q

Metabolic alkalosis possible causes:

A

Inadequate excretion of acids due to renal disease

Loss of hydrochloric acid from prolonged vomiting or gastric suctioning

Loss of potassium due to increased renal excretion

Steroid overdose

Excessive alkali ingestion

61
Q

Respiratory Acidosis signs and symptoms =

A

hypercapnia (increased CO2)
hypoventilation
headache
visual disturb
confusion
coma/drowsiness
hyperalkemia

62
Q

Metabolic Acidosis signs and symptoms =

A

bicarbonate deficit
hyperventilation
headache
mental dullness
deep respiration
coma/stupor
cardiac arrhythmias

63
Q

What is alveolar hyperventilation?

A

leads to a PaCO2 less than normal

ratio with bicarbonate increases = blood pH increases = respiratory alkalosis

bicarbonate/CO2

64
Q

What is alveolar hypoventilation?

A

leads to a PaCO2 greater than normal

ratio with bicarbonate decreases = blood pH decreases = respiratory acidosis

65
Q

What is it called when a patient’s PaCO2 is > 50mmHg ?

A

Ventilation Failure = alveoli unable to remove CO2

66
Q

Pulmonary Assessment: ABG: PaO2

A

75 and 100 mm Hg at sea level = As altitudes increase, normal values decrease

Air that we breath in is approximately 21% Oxygen

Total pressure of all of the gases you breathe = oxygen, nitrogen, carbon dioxide

67
Q

Oxygenation status is determined by PaO2 levels:

A

80 – 100 mmHg - normal

between 60-80mmHg-mildly hypoxemic

between 40-60mmHg- moderate hypoxemic

under 40mmHg- severe hypoxemic

68
Q

Hypoxemic Respiratory Failure: Type I

A

PaO2 <60 mmHg (decrease)
Hypoventilation (PaCO2 increases)
V/Q mismatch
Diffusion limitation

Pneumonia, COPD, atelectasis/lobar collapse, ARDS Intrapulmonary shunt = fluid filled alveoli that are perfused but not ventilated

69
Q

What is the most common form of respiratory failure?

A

Hypoxemic Respiratory Failure: Type I

70
Q

Hypercapnic Respiratory Failure: Type II

A

PaCO2 >50mmHg (increase)

Hyperventilation to compensate for high CO2

Compensation = Renal response, takes days to weeks

71
Q

What causes Hypercapnic Respiratory Failure: Type II ?

A

Respiratory Center (medulla) dysfunction = drug overdose, CVA, tumor

Neuromuscular Disorders = SCI, Guillain-Barre, ALS, MD

Chest Wall/Pleural Diseases = Kyphosis, scoliosis, pneumothorax, massive pleural effusion

Upper Airway Obstruction = Tumor, foreign body, laryngeal edema

72
Q

Respiratory Failure: Clinical Manifestations

A

Dyspnea –secondary to hypercapnia and hypoxemia

Altered breathing pattern

Cyanosis –poorly oxygenated hemoglobin

Circulatory changes –tachycardia, hypertension, or hypotension

Mental status changes –confusion, somnolence, convulsions, coma

Adventitious or absent lung sounds

73
Q

Treatment of Respiratory Failure

A

Hypoxemia can cause death

Treat underlying cause = hypoxemia = hypoxia

Medical Management = Pharmacologic

PT Management = breathing strategies, strengthening, pacing

Supplemental oxygen : amount primarily determined by PaO2 and/or PaCO2

74
Q

When does tissue hypoxia occur?

A

Pa02 <38mmHg or Sa02< 70%

Need to Increase to minimum levels of: Pa02>60mmHg and Sa02>87%02

75
Q

What is SAO2?

A

measurement of oxygen saturation in arterial blood

measured by blood gas analysis

measured in peripheral blood taken from an artery through puncturing

measures the oxygen saturation of both functional and non-functional hemoglobin

important ot determine anemic conditions

76
Q

What is SPO2?

A

oxygen saturation in the arterial blood measured as a pulse oximeter

measured by the pulse oximetry

noninvasive method - uses a transmissive pulse oximeter

measures the oxygen saturation of only functional hemoglobin

important in surgery and post-anesthetic care units, neonatal care and NICU, emergency care, noninvasive transcutaneous pacing

Cardio pulm exam 2 (8 decks)

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