Week 3 - Point of care devices- blood gas and urine analysis

Question 1

what are some of the advantages of point of care testing?

Answer 1

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

Question 2

what are the disadvanatge of point of care testing by paramedcis?

Answer 2

information overload
costs
logistics of devices in pre-hopsital setting
interpretation
time consuming, critical thinking,

Question 3

what is the difference between type one and type 2 errors?

Answer 3

one- false positive
two - faulse negative

Question 4

what can the specific gravity of urine tell us?

Answer 4

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

Question 5

what can the pH of urine tell us?

Answer 5

normal 4.5-8

Question 6

what can leukocytes in urine tell us?

Answer 6

white blood cells- signs of an infection

Question 7

what does nitrate in the urine tell us?

Answer 7

precence of gram-negative bacteria in the urine- UTI

Question 8

what can the presence of blood in urine tell us?

Answer 8

cuases of haematuria- trauma, infection, inlmation,

Question 9

what things do we look out for on urinanalyis for different diseaseS?

Answer 9

renal colic - heamaturia
UTI- nitrates and leukocytes
Dehydration- High specific graviy and ketones
liver issue- bilirubin
DM/kidney issues- glucose and protiens

Question 10

what are the 4 key fucntions of electrolytes in the body?

Answer 10

certain ions control the osmosis of water between fluid compartments
help maintain acid balance
carry eletrical current
serve as cofactors

Question 11

what is the normal range of extra cellular sodium?

Answer 11

135-145

Question 12

what does sodium do in the body?

Answer 12

maintains extracellular fluid osmolarity
attracts fluids
transmits impulses in nerve fibers

Question 13

what is hypernatrima? what causes it and the symptoms?

Answer 13

causes- dehydration, water deprovation, excessive sodium diet

Sings and symptoms- intense thirst, hypertnesion, odeama, agitation, convulsions

Question 14

what is hyponatrimua?

Answer 14

causes - drink too much water,

Lethargy, muscular weakness, confusion, seizures, coma, hypotension, tachycardia, shock

Question 15

what is the normal range for extracellular potassium?

Answer 15

3.5-5.5

Question 16

what does potassium do?

Answer 16

most abundant ICF
key role in resting membrane potential
repolorisation of action potentils

Question 17

what is hyperkaemia?

Answer 17

> 5.5
causes- potassium intake, renal failure, aidosterone deficeny
cruch injuries

symptoms- iritability, GIT disturbances, arythmias, muscular weakness

Question 18

what is hypokalemia?

Answer 18

<3.5 potassium
caused by
excessive loss- vommiting
decreased intake
renal disaease

sings- muscle fatiuge, flacid, paralyis, confusion, t wave flatterning, shallow respiratiosn

Question 19

what are the three buffer systems in the bd=ody that respond to pH changes?

Answer 19

protein
phosphate
carbonic acid-bicarbonate buffer system

Question 20

what happens when the blood is acidotic and alkalotic?

Answer 20

ph <7.35 acidotis
CNS depression, coma, death

PH >7.45
CNS and peripheral nervs
nerousness, muscle spasms, convulsions, death

Question 21

what are the steps in interpreting an ABG?

Answer 21

clinical context
pH- acidotic or alkalotic
C02- elevated or not
HCO3-

Question 22

what are the normal values for ph, co2 and HCO3?

Answer 22

ph 7.35-7.45
CO2 35-45
HCO3 22-26

Question 23

what causes resp acidosis?

Answer 23

not enough CO2 breathed off - conditions that cause hypoventelation
COPD, actelectisis, drug over dose, anestesia probleas

Question 24

what causes resp alkalosis?

Answer 24

breathing off too much co2
anxiety, fear, hyperventelation, mechanical ventelation problems

Question 25

how do we correct respitroy acidosis/alcalosis?

Answer 25

acidosis- breath off more co2- increase resps or administer bi carbonate

alkalosis- increase concerntration of co2 - slow breathing

Question 26

what causes metabolic acidosis/alkalosis?

Answer 26

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

Question 27

what is the treatment for metabolic acidosis/alkalosis?

Answer 27

acidosis - administer bicarbonate and correcting causes

alkalosisi - correcting electrolytes and causes

Question 28

what are the signs and symptoms of resp acidosis?

Answer 28

drowsiness, dizziness, disorientation, reduced bp due to vasodilation, dysrythmias, hyperkalemia