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ClinChem Test3
Chpt 9 Assessment of Respiratory Disorders
| Question | Answer |
|---|---|
| Glycolysis will | falsely decrease the pH and PO2 and increase PCO2 |
| Blood Gas Machines typically require QC to be performed | every 8 hours |
| Blood Gas Machines typically Measure | pH, PCO2, PO2, OSAT, CO, MET |
| Blood Gas Machines typically Calculate | TCO2/ HCO3, Base Excess |
| Patients body temp can affect results and should be collected to make corrections | for PCO2 and PO2 |
| Fever or lowering body temp for surgery can greatly affect the results of | the blood gas |
| Arteries typically used for arterial collection: | Radial, Brachial, Femoral |
| Acid base status is determined by comparing the pH of the sample to the reference range. If pH of sample is below the reference range then the patient is | acidotic |
| Common causes of metabolic acidosis include: | diseases such as diabetic ketoacidosis (DKA), uremia, renal tubular acidosis, lactic acidosis, and the GI loss of bicarbonate, fluid, and potassium |
| Another example of metabolic acidosis arises from hypotension secondary to dehydration, which leads to | poor tissue perfusion, lactic acid formation, and fluid and electrolyte imbalance |
| Metabolic alkalosis may stem from | vomiting or gastric suctioning, low potassium or chloride levels, and liver cirrhosis with ascites, corticoid excess, and massive blood transfusion |
| Respiratory Acidosis can result from disease of the respiratory system that cause CO2 retention : | Chronic Obstructive Pulmonary Disease (COPD) Blue Bloaters |
| Respiratory Alkalosis can result from respiratory or systemic diseases that cause | hyperventilation and CO2 deficit |
| The following five factors must be considered to interpret acid-base balance: | pH, HCO3,Pco2,anion gap and assessment for compensation |
| There is a direct relationship between HCO3 and pH based on which equation | Henderson-Hasselbalch equation |
| Henderson-Hasselbalch equation | CO2 + H2O = H2CO3 = H+ Hco3- |
| If both pH and HCO3 are decreased this is | Metabolic Acidosis |
| If both pH and HCO3 are increased this is | Metabolic alkalosis |
| There is an INVERSE relationship between | pH and Pco2 |
| If HCO3 is within the reference range and Pco2 is elevated and the patient is acidotic the condition | is respiratory acidosis |
| If HCO3 is within the reference range and Pco2 is decreased but the patient is alkalotic | then the condition is respiratory alkalosis |
| in metabolic or mixed acidosis | the anion gap is significantly elevated |
| the pH, HCO3, and Pco2 are considered together to determine if | compensation is occurring |
| Ventilation is inversely proportional to | Pco2 |
| The respiratory system responds rapidly to a change in CSF pH, more so than | blood pH |
| Po2 is the partial pressure of oxygen which is dissolved in the plasma as well as the | oxygen saturation So2 |
| Hypoxia, decreased supply of oxygen to tissues is determined based upon | Arterial Po2 |
| The hemoglobin molecule can retain or release oxygen at different rates depending upon certain conditions such as | pH,Pco2, temperature, or 2,3-DPG levels |
| In general as pH decreases or as Pco2, temperature, and/or 2,3 DPG increase, the oxygen dissociation curve shifts to the | right, indicating that hemoglobin molecule has a lower affinity to oxygen |
| Two specific diseases fall within the COPD category they are | emphysema, an chronic bronchitis |
| When CO2 is retained it initiates | renal compensation, the kidneys retain HCO3 in an effort to return the pH to normal. This leads to increased levels of HCO3 and Pco2 in the body. |
| At the other end of the COPD spectrum are the “blue bloaters” they are | overweight, edematous and cyanotic |
| If the kidneys are unable to retain additional HCO3 to combat the rising pH due to CO2 retention then pH remains acidotic. | This is described as as acute-on-chronic CO2 retention and is associated with ARDS |
| Infants born before 37 weeks or weighing less than 2500g frequently experience respiratory distress from a lack of | lung maturity |
| Oxyhemoglobin (O2Hb)can be measured using a | co-oximeter, a dedicated spectrophotometer |
| Total Hemoglobin is a product of adding | Oxyhemoglobin to Deoxyhemoglobin |
| Percent saturation = | [O2Hb/(O2Hb+HHb)] X 100% |
| Transcutaneous monitoring of oxygen saturation can NOT measure dysfunctional forms of hemoglobin such as | Carboxyhemoglobin, and Methemoglobin |
| These must be ruled out with an arterial puncture and direct measurement of | Oxyhemoglobin |
| CO is | the most commonly encountered toxic gas |
Created by:
Mgoodall
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