Week 3 - Point of care devices- blood gas and urine analysis Flashcards
what are some of the advantages of point of care testing?
assessing and managing paitents at home
detailed triage of paitents
screening patients in the community
detect blood loss
INR follow up
diagnostic tests for chest pain
what are the disadvanatge of point of care testing by paramedcis?
information overload
costs
logistics of devices in pre-hopsital setting
interpretation
time consuming, critical thinking,
what is the difference between type one and type 2 errors?
one- false positive
two - faulse negative
what can the specific gravity of urine tell us?
amount of solutes as compared to water
decresed <1.0005 - inability to cncerntrate or excessive hydration
Increased >1.035 dehydration, adrenal insufficency, renal/liver failure
what can the pH of urine tell us?
normal 4.5-8
what can leukocytes in urine tell us?
white blood cells- signs of an infection
what does nitrate in the urine tell us?
precence of gram-negative bacteria in the urine- UTI
what can the presence of blood in urine tell us?
cuases of haematuria- trauma, infection, inlmation,
what things do we look out for on urinanalyis for different diseaseS?
renal colic - heamaturia
UTI- nitrates and leukocytes
Dehydration- High specific graviy and ketones
liver issue- bilirubin
DM/kidney issues- glucose and protiens
what are the 4 key fucntions of electrolytes in the body?
certain ions control the osmosis of water between fluid compartments
help maintain acid balance
carry eletrical current
serve as cofactors
what is the normal range of extra cellular sodium?
135-145
what does sodium do in the body?
maintains extracellular fluid osmolarity
attracts fluids
transmits impulses in nerve fibers
what is hypernatrima? what causes it and the symptoms?
causes- dehydration, water deprovation, excessive sodium diet
Sings and symptoms- intense thirst, hypertnesion, odeama, agitation, convulsions
what is hyponatrimua?
causes - drink too much water,
Lethargy, muscular weakness, confusion, seizures, coma, hypotension, tachycardia, shock
what is the normal range for extracellular potassium?
3.5-5.5
what does potassium do?
most abundant ICF
key role in resting membrane potential
repolorisation of action potentils
what is hyperkaemia?
> 5.5
causes- potassium intake, renal failure, aidosterone deficeny
cruch injuries
symptoms- iritability, GIT disturbances, arythmias, muscular weakness
what is hypokalemia?
<3.5 potassium
caused by
excessive loss- vommiting
decreased intake
renal disaease
sings- muscle fatiuge, flacid, paralyis, confusion, t wave flatterning, shallow respiratiosn
what are the three buffer systems in the bd=ody that respond to pH changes?
protein
phosphate
carbonic acid-bicarbonate buffer system
what happens when the blood is acidotic and alkalotic?
ph <7.35 acidotis
CNS depression, coma, death
PH >7.45
CNS and peripheral nervs
nerousness, muscle spasms, convulsions, death
what are the steps in interpreting an ABG?
clinical context
pH- acidotic or alkalotic
C02- elevated or not
HCO3-
what are the normal values for ph, co2 and HCO3?
ph 7.35-7.45
CO2 35-45
HCO3 22-26
what causes resp acidosis?
not enough CO2 breathed off - conditions that cause hypoventelation
COPD, actelectisis, drug over dose, anestesia probleas
what causes resp alkalosis?
breathing off too much co2
anxiety, fear, hyperventelation, mechanical ventelation problems
how do we correct respitroy acidosis/alcalosis?
acidosis- breath off more co2- increase resps or administer bi carbonate
alkalosis- increase concerntration of co2 - slow breathing
what causes metabolic acidosis/alkalosis?
acidosis - DKA, retention of too much H ions - renal failure
production too much CO3- liver failure
secretion too much co3- diareha, fistuals
Alkalosis - excessive vomitting, diarhea, endocrine disorders
what is the treatment for metabolic acidosis/alkalosis?
acidosis - administer bicarbonate and correcting causes
alkalosisi - correcting electrolytes and causes
what are the signs and symptoms of resp acidosis?
drowsiness, dizziness, disorientation, reduced bp due to vasodilation, dysrythmias, hyperkalemia
