Chpt 9 Assessment of Respiratory Disorders
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| Glycolysis will | falsely decrease the pH and PO2 and increase PCO2
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| Blood Gas Machines typically require QC to be performed | every 8 hours
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| Blood Gas Machines typically Measure | pH, PCO2, PO2, OSAT, CO, MET
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| Blood Gas Machines typically Calculate | TCO2/ HCO3, Base Excess
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| Patients body temp can affect results and should be collected to make corrections | for PCO2 and PO2
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| Fever or lowering body temp for surgery can greatly affect the results of | the blood gas
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| Arteries typically used for arterial collection: | Radial, Brachial, Femoral
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| 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
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| 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
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| 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
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| 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
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| Respiratory Acidosis can result from disease of the respiratory system that cause CO2 retention : | Chronic Obstructive Pulmonary Disease (COPD) Blue Bloaters
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| Respiratory Alkalosis can result from respiratory or systemic diseases that cause | hyperventilation and CO2 deficit
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| The following five factors must be considered to interpret acid-base balance: | pH, HCO3,Pco2,anion gap and assessment for compensation
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| There is a direct relationship between HCO3 and pH based on which equation | Henderson-Hasselbalch equation
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| Henderson-Hasselbalch equation | CO2 + H2O = H2CO3 = H+ Hco3-
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| If both pH and HCO3 are decreased this is | Metabolic Acidosis
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| If both pH and HCO3 are increased this is | Metabolic alkalosis
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| There is an INVERSE relationship between | pH and Pco2
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| If HCO3 is within the reference range and Pco2 is elevated and the patient is acidotic the condition | is respiratory acidosis
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| If HCO3 is within the reference range and Pco2 is decreased but the patient is alkalotic | then the condition is respiratory alkalosis
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| in metabolic or mixed acidosis | the anion gap is significantly elevated
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| the pH, HCO3, and Pco2 are considered together to determine if | compensation is occurring
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| Ventilation is inversely proportional to | Pco2
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| The respiratory system responds rapidly to a change in CSF pH, more so than | blood pH
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| Po2 is the partial pressure of oxygen which is dissolved in the plasma as well as the | oxygen saturation So2
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| Hypoxia, decreased supply of oxygen to tissues is determined based upon | Arterial Po2
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| 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
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| 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
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| Two specific diseases fall within the COPD category they are | emphysema, an chronic bronchitis
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| 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.
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| At the other end of the COPD spectrum are the “blue bloaters” they are | overweight, edematous and cyanotic
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| 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
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| Infants born before 37 weeks or weighing less than 2500g frequently experience respiratory distress from a lack of | lung maturity
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| Oxyhemoglobin (O2Hb)can be measured using a | co-oximeter, a dedicated spectrophotometer
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| Total Hemoglobin is a product of adding | Oxyhemoglobin to Deoxyhemoglobin
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| Percent saturation = | [O2Hb/(O2Hb+HHb)] X 100%
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| Transcutaneous monitoring of oxygen saturation can NOT measure dysfunctional forms of hemoglobin such as | Carboxyhemoglobin, and Methemoglobin
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| These must be ruled out with an arterial puncture and direct measurement of | Oxyhemoglobin
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| CO is | the most commonly encountered toxic gas
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