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YEAR 2 CR > week3 > Flashcards

week3 Flashcards

1
Q

whats pi02

A

inspired oxygen

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2
Q

whats PA02

A

alveolar ocygen

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3
Q

whats Pa02

A

arterial 02

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4
Q

whats P02

A

cellualr O2

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5
Q

concentration of O2 in air

A

21%

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6
Q

whast air barometric pressure

A

100kPA

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7
Q

whats Po2 of dry air at sea level

A

21kPa

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8
Q

is tracheal gas higher or lower than inspired o2

A

less so because it gets humidified. its about 19.9 Kpa alors que inspired is 21kPa

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9
Q

Factors affecting alveolar PAo2

A

alveolar ventilation

oxygen consumption/Co2 production

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10
Q

what happens to PaO2 when alveolar ventilation increases

A

increases but will never reach PiO2 bc there will always be some Co2 in the lungs

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11
Q

equation for alveolar Po2

A

PAO2 = PiO2 - (PaCo2/R 0.8)

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12
Q

factor affecting alveolar to arterial po2 difference

A

shunting so as in not going through the lungs which causes relative desaturation

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13
Q

whats the nrmal alveolar to arterial po2 difference

A

less than 1.13 Kpa

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14
Q

normal PaO2 in kpa

A

11KPA (13.6 - (0.044 x age in years)

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15
Q

shape of oxygemoglobing cuve shape

and three main points

A

sigmoid
97% hemoglovbin saturation at 10 Kpa
74% hemoglobin saturation at 5.3 Kpa
50 (P50) hemoglobin saturation at 3.5 kpa

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16
Q

what does oxygen delivery depend on

and formula

A

oxygen satruation
hemogloin conc
CO
Hefners constant

conc Hb x ocygen satu x 1.34 x CO

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17
Q

what are the signs of respiratory failyre

A
  • high respiratory compensattion (tachyponoa, use of acc muscles, nostril flaring, intercostal or sternal recession)
  • increase sym tone (tachycardia, hyeprtension, sweating)
  • jhemoglobin destaruation (cyanosis)
  • end organ hypoxia (hypotension and bradychardia after some time and altered mental state)
  • Co2 retention (flap, boudning pulse)
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18
Q

what are the two forms of respiratory failure adn expalin them

A

type I and type II

in type I you have hypoxemia only (less than 8 Kpa)
in type II you have hypoxemia (less han 8 kopa) and hypercapneia (over 6.5 kpa)

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19
Q

what conditions would present as type I resp failure

A

pneumonia, pneumothorax, pulmonary embolis, pum ededma, ateeltasis, collapse

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20
Q

what conditions would present as type II resp fialure

A

type I with fatigue

hypoventilation caused by depressant drugs, neuromuscular dx, brasitem pb, nerve trauma

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21
Q

indication for o2 therapy

A 
resp fialure
cardiac or resp arrest
tachypnoea
cyanosis
hypotension
metabolic acidosis
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22
Q

types of oxygen masks

A

Low flow masks

high flow masks

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23
Q

Peak inspiratory volume at rest

A

15L/min

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24
Q

Peak inspiratory volume at distress

A

30L/min

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25
Q

low flow masks vs high flow makss

A
  • low flow are like nasal canula, simple face maks or wiht sotrage). deliver variable amounts of 02. deliver less than PIF. so amount of 02 delivered depends on pts ventilator abilites
  • high flow like venturi mask (deliver constant ocygen level and more so than PIF)
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26
Q

which maks for post op or pt with normal vital signs

A

nasal cannula

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27
Q

which maks for pt w astham, pneumonia, sepsis

A

low flow mask with reservoir bag

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28
Q

which mask for controlled long term tratemnt of COPD

A

ventiru mask

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29
Q

venturi color and flow rate and 02 delivered

A 
blue 2 24
white 4 28
yellow red 6 35
red 8 40
green 12 60
30
Q

what to monitor while giving oxygen therapy

A

ABG

vital signs

31
Q

critical thresolhf for SPO2

A

94%. under that is hypoxemia, bc after that any lower drop of Pa02 will give a sig drop in Sp02

32
Q

what does pulse oximetry tell you

A

about oxygenation not ventirlation

33
Q

source of error in pulse oximetry

A

color skin
nails
poor peripheral perfusion
excessive motion

34
Q

what should Kpa be if SPo2 is over 94

A

over 10 Kpa

35
Q

shoudl you give a lot of extra 02 or a little

A

minimum sinon oxygen radical s

36
Q

what are c02 retainers

A

ppl who retian a lot of co2. due to gas exchange impariemnt

37
Q

management of pt with unsure co2 reptainer

A

start high flow oxygen (venturi mask)
moniotr for drowniess, sx of co2 reatiner
check ABG after 30mins

38
Q

management of pt with SURE co2 reptainer

A 
starts high flow oxygen (venturi mask)
chekc ABG ASAP
titrate- use lowest 02 possible
aim for sat 90 to 92
repeat ABG after 30 mons
39
Q

when to call for help with patient

A 
requiring 60% to mainting ok vitals
severe tachypnoe a(over 30bpm)
confusion/LOC
Ph les than 7.2
pco2 over 8kpa
40
Q

use ventialtion to correct hypoxia=?

A

NOOOO
ventialtion used for hypercapnea
give 02 for hypoxia and ventilate inhypercapnoa

41
Q

treatment for hypoxia

A

02

42
Q

machine of spirometry

A

spirometer

43
Q

functin of spirometer

A

measures expired and inspired air

44
Q

pt requirements for spirometry test

A

not tihgt clothers

sitting upright

45
Q

technique for spirometry

A

patient tkaes deep in wiht the mouthpiece. then out very quickly, then in and maximum out.

46
Q

gold standard test for OPD

A

spirometry

47
Q

gold standrad test for RPD

A

DLCO

48
Q

whats tidal volume

A

air in / out at rest

49
Q

inspiratory reserve volume

A

volume of air you can draw into your lungs

50
Q

expiratoyr reserve volume

A

volume of air you can expel from your lungs

51
Q

residual volume

A

volume of air that remains in your lungs even after max exhalation

52
Q

forced vital capacity and formula

A

max air in and out in 1 resp cycle .

FVC: inspiration reserve plus tidal volume, plus expiratory rserve

53
Q

what vaues of spiro are reducxed in astham

A

lower FEV1. lower FVC, lower PEF and reduced flwo rate,

54
Q

factors affecting spiromteyr

A

race
height
gender
age

55
Q

how doe the flow volume loop change in astham

A

left shifting

56
Q

how doe the flow volume loop change in COPD

A

right shifting

57
Q

what happens to FEV1:FVC ratio in asthma

A

it dexreases because FEV1 reduces mroe significiantly

58
Q

what happens to FEV1:FVC ratio in COPD

A

it increases because FVC reduces mroe significiantly

59
Q

is lung volume higher or lower than normal in asthma

A

higher

60
Q

is lung volume higher or lower than normal in COPD

A

lower

61
Q

normal FEV1 value

A

70-80%

62
Q

whats the funciton test to measurerespitary gas trasnfer

A

DLCO TLCO

63
Q

what does DLCO meaysre

A

how efficient lungs are at exhcnaging gas

  • ability of lungs ot trasnfer gas from inhaled air to RBC
  • diffusing capacity of the lungs for CO
64
Q

how do you perform DLCO

A

unforced exchakation to residucal volume then rapid inhalation of CO/helium to TLC then rbeath hold 10s then unforced exhalation less htan 4s.

65
Q

unit of DLCO

A

ml/min/mmHG

66
Q

DLCO formula

A

lung sufarce area availbe for gas trasfer x rate of capillary blood CO uptake (Kco)

67
Q

which fcotr of the FLCO formula is refuced in ILD

A

rate of capillary blood uptake of CO

68
Q

when is the use of DLCO useufl and problematic

A

useufl for dx of early ILD

not useful bc falsely reduces in individual who fail to inspire to TLC and so significifant refuxitonsl

69
Q

when are exercise test useful

A

asssess how mnuch a pt is able to manage
assess benefit fo extras oxgen therapy to hekpo
asses preop fitness
part of rehab progrma

70
Q

examples of exercises of tests

A 
6 min walk on falt surfce. meausr eox sat after. and assess breahtless
shuttle walk (asses distance and speed swlak)
cardiopulmonary exercise (assess preop fitness)
71
Q

test to assess preop fitness

A

cardiopulmonary exercxse

YEAR 2 CR (3 decks)

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