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63 Cards in this Set
- Front
- Back
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HCO3 Sea Level Values
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22-26
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HCO3 Albuquerque Values
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18-26
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PACO2 Albuquerque Values
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33-38
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Mild Hypoxemia in ABQ
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50-60
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Moderate Hypoxemia in ABQ
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40-50
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Severe Hypoxemia in ABQ
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below 40
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List 3 causes of hypercapnia
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-hypoventilation
-increased dead space -increased CO2 production |
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List 3 respiratory causes of Respiratory Acidosis
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- Late stage COPD
-Upper Airway Obstruction -Pulmonary Edema |
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List 3 non-respiratory causes of Respiratory Acidosis
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-Drug OD
-Spinal cord trauma -head trauma |
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List 2 respiratory causes of Respiratory alkalosis
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-early stage asthma
-restrictive disorders |
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List 2 metabolic causes of respiratory alkalosis
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- exercise
- fever -bactermia |
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List 2 psychergenic causes of respiratory alkalosis
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- anxiety
- pain -neurosis |
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List 2 causes of metabolic acidosis with the loss of hco3
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-diarrhea
- surgical drains |
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List 3 causes of metabolic acidosis with the gain of acid
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-sepsis, heart failure (lactic acidosis)
- ketoacidosis (diabetic, alcoholic) - kidney failure - poison - aspirin OD |
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List 3 causes of metabolic alkalosis
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- hypochloremia (decreased CL-)
- Hypokalemia (decreased K+) - NG suction - Persistant Vomiting - Diuretic therapy - Steroid Therapy - Excessive administration of sodium bicarbonate |
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List 5 causes of hypoxemia
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-decreased inspired O2
-shunt -V/Q mismatch -Hypoventilation -Diffusion Abnormality |
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What is the henderson-hasselbach equation
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ph=pK + log (HCO3-/H2CO3)
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What angle do you use for the femoral artery
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90 degrees
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list hazards/complications from ABG's
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-hematoma
-arterio-spasm -air or clotted blood emboli -anaphylaxis from local -anesthetic -infection -hemorrhage -trauma to vessel -arterial occlusion -vasovagal response -nerve injury -pain |
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List 2 qualifying conditions for home O2
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PaO2 <55
SaO2 <88% |
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List O2 conditions for cor pulmonale
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PAO2 56-59
SPO2 <89% |
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What is the volume of gas in the lungs at maximum inspiration
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TLC
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What is the maximum volume of gas that can be inhaled after a normal exhalation
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IC
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Maximum volume of gas that can be exhaled after a maximal inhalation or the maximum volume of gas that can be inhaled after a maximum exhalation
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VC
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Volume of gas that remains in the lungs after a normal exhalation
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FRC or Vtg
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The volume of gas that can be inhaled above a normal inhalation
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IRV
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The amount of gas inhaled or exhaled during normal breathing
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VT
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The volume of gas exhaled after a normal exhalation
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ERV
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The volume of gas remaining in the lungs after maximal exhalation
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RV
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Spirometery Contraindications
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-Hemoptysis of unknown origin
-pneumothorax -unstable cardiovascular status (MI < 30 days) -thoracic, abdomincal, or cerebral aneurysms -Facial, muscular/skeletal, or abdominal pain - recent eye surgery - stress incontinence - dementia |
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Obstructed patients have what type of FEV1/FVC ratio
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<75% of predicted
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What disease process shows a decrease in lung volumes without a decrease in airflow in PFT's
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Restrictive process
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Restricted patients have what type of FVC
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<80% of predicted
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What disease process shows a decrease in airflow without a decrease in lung volumes
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obstructive process
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What is the qualifying positive bronchodilator response?
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+12%
200cc increase |
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Whats the bronchodilator response formula
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(post-pre/pre) x 100
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What's the peak flow formula
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(Highest PEFR-Lowest PEFR/Highest PEFR) x 100
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What is the FVC repeatability criteria
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The 2 largest FVC and FEV1 of the 3 should be less than or equal to 150cc of each other
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FRC is measured how?
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-Plethysmography
-N2 washout -He dilution |
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How are RAW and GAW measured?
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Plethysmography
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You should always keep the pressure cuff below ____ to prevent aspiration while on the ventilator
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-20 cm H2O
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How much pressure can cause tracheal damage
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25
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You maintained what type of system for positive pressure ventilation
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closed system
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How far do you keep the ET tube above the carina
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2-5 cm
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Oropharyngeal airway indications
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-Airway obstructed by the tongue
-Pooled secretions/blood in the upper airway -Need for bag/mask ventilation -biting tongue/ ETT |
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Oropharyngeal airway hazards
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-Gagging/ aspiration
- Oral injury - Increased obstruction - Gastric Inflation |
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Oropharyngeal contraindications
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-Intact gag reflex
-fractured jaw/facial trauma |
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List the 6 weaning parameters you need to know
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- VT
- Minute Ventilation - Vital Capacity - MVV - NIF - Tobin Index |
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What is the VT needed before extubation
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500cc
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What is the Minute Ventilation needed before extubation
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< 10 Imp
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What is the Vital Capacity needed before extubation
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> 15 ml/kg of ideal body weight
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What is the NIF needed before extubation
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-20 cm H2O pressure
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What is the Tobin index needed before extubation
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< 105 (rr/vt)
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What is a device that measures flow using different physical principles
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pneumotachometers
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list 3 parts of flow sensing pneumotachometers
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pressure differential
rotating vane heated wire |
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List the order of the reflexes of the upper airway
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swallow
gag laryngeal tracheal carina |
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What nerve is responsible for a patients decreased BP, HR, and laryngospasm during intubation, extubation and suctioning
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vagus
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What wave form has cm H2O
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Pressure wave form
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What wave form has LPM
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Flow wave form
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Which wave form has ml
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volume wave form
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What is the formula for dynamic compliance
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vt/PIP-PEEP
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What is the formula for static compliance
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vt/plateau-PEEP
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What is the formula for RAW
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(PIP-Plateau)/Flow
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