week3 Flashcards by lilya SH

whats pi02

inspired oxygen

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whats PA02

alveolar ocygen

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whats Pa02

arterial 02

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whats P02

cellualr O2

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concentration of O2 in air

21%

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whast air barometric pressure

100kPA

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whats Po2 of dry air at sea level

21kPa

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is tracheal gas higher or lower than inspired o2

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

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Factors affecting alveolar PAo2

alveolar ventilation

oxygen consumption/Co2 production

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what happens to PaO2 when alveolar ventilation increases

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

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equation for alveolar Po2

PAO2 = PiO2 - (PaCo2/R 0.8)

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factor affecting alveolar to arterial po2 difference

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

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whats the nrmal alveolar to arterial po2 difference

less than 1.13 Kpa

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normal PaO2 in kpa

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

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shape of oxygemoglobing cuve shape

and three main points

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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what does oxygen delivery depend on

and formula

oxygen satruation
hemogloin conc
CO
Hefners constant

conc Hb x ocygen satu x 1.34 x CO

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what are the signs of respiratory failyre

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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what are the two forms of respiratory failure adn expalin them

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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what conditions would present as type I resp failure

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

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what conditions would present as type II resp fialure

type I with fatigue

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

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indication for o2 therapy

resp fialure
cardiac or resp arrest
tachypnoea
cyanosis
hypotension
metabolic acidosis

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types of oxygen masks

Low flow masks

high flow masks

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Peak inspiratory volume at rest

15L/min

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Peak inspiratory volume at distress

30L/min

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low flow masks vs high flow makss

- 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)

which maks for post op or pt with normal vital signs

nasal cannula

which maks for pt w astham, pneumonia, sepsis

low flow mask with reservoir bag

which mask for controlled long term tratemnt of COPD

ventiru mask

venturi color and flow rate and 02 delivered

``` blue 2 24 white 4 28 yellow red 6 35 red 8 40 green 12 60 ```

what to monitor while giving oxygen therapy

ABG | vital signs

critical thresolhf for SPO2

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

what does pulse oximetry tell you

about oxygenation not ventirlation

source of error in pulse oximetry

color skin nails poor peripheral perfusion excessive motion

what should Kpa be if SPo2 is over 94

over 10 Kpa

shoudl you give a lot of extra 02 or a little

minimum sinon oxygen radical s

what are c02 retainers

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

management of pt with unsure co2 reptainer

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

management of pt with SURE co2 reptainer

``` 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 ```

when to call for help with patient

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

use ventialtion to correct hypoxia=?

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

treatment for hypoxia

machine of spirometry

spirometer

functin of spirometer

measures expired and inspired air

pt requirements for spirometry test

not tihgt clothers | sitting upright

technique for spirometry

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

gold standard test for OPD

spirometry

gold standrad test for RPD

DLCO

whats tidal volume

air in / out at rest

inspiratory reserve volume

volume of air you can draw into your lungs

expiratoyr reserve volume

volume of air you can expel from your lungs

residual volume

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

forced vital capacity and formula

max air in and out in 1 resp cycle . | FVC: inspiration reserve plus tidal volume, plus expiratory rserve

what vaues of spiro are reducxed in astham

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

factors affecting spiromteyr

race height gender age

how doe the flow volume loop change in astham

left shifting

how doe the flow volume loop change in COPD

right shifting

what happens to FEV1:FVC ratio in asthma

it dexreases because FEV1 reduces mroe significiantly

what happens to FEV1:FVC ratio in COPD

it increases because FVC reduces mroe significiantly

is lung volume higher or lower than normal in asthma

higher

is lung volume higher or lower than normal in COPD

lower

normal FEV1 value

70-80%

whats the funciton test to measurerespitary gas trasnfer

DLCO TLCO

what does DLCO meaysre

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

how do you perform DLCO

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

unit of DLCO

ml/min/mmHG

DLCO formula

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

which fcotr of the FLCO formula is refuced in ILD

rate of capillary blood uptake of CO

when is the use of DLCO useufl and problematic

useufl for dx of early ILD | not useful bc falsely reduces in individual who fail to inspire to TLC and so significifant refuxitonsl

when are exercise test useful

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

examples of exercises of tests

``` 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) ```

test to assess preop fitness

cardiopulmonary exercxse

week3 Flashcards

(71 cards)