ABG’s if respiratory acidosis
pH < 7.35, pCO2 > 45, HCO3> 26 if compensating
causes of respiratory acidosis
CNS depression from drugs
Respiratory arrest
Hypoventilation from pulmonary, cardiac or neuromuscular disease
signs of respiratory acidosis
Tachycardia, tachypnea early, then bradypnea, confusion, hypotension, lethargy, coma
ABG’s if respiratory alkalosis
pH > 7.45, pCO2< 35, HCO3 <22 if compensating
causes of respiratory alkalosis
Hyperventilation from anxiety, pain or vent settings
Respiratory stimulation by drugs, disease, fever
Gram-negative bacteremia
Pulmonary emboli
signs of respiratory alkalosis
Confusion, light-headedness, anxiety, palpitations, paresthesias
metablic alkalosis if…
vomiting/diarrhea/ GI fistulas
metabolic acidosis if…
DKA and renal failure
cannot excrete hydrogen ions (renal): acidodic
are not exchanging glucose, slows down NaK pump… hold on to acid (DKA): acidodic
how do you know if respiratory or metabolic problem??
If respiratory then pO2 is affected, not so in metabolic
how do you know if compensating or not
Compensated if pH is normal! Uncompensated if pH is not normal
describe emphysema
- Fibrous type lungs filled with CT (grown d/t emphysema)
- Decrease in lastase (lung become fibrotic)
- Process of making fibrous tissue: continuous inflammatory process (chronic)
causes of emphysema
- smoking, inhaled particles, vaping, black lung disease, smoke/smog
- cannot get CO2 out of lungs
describe COPD
- do not have good expansion (appears like a barrel chested, dead lung)
- x ray is too dark/black, should see some lighting
- AP diameter is too wide
what does pneumonia x ray look like
- big old junk
- bacteria in the lungs, full of protein: pulls more fluid into lungs
what does pulmonary edema x ray look like
- Whispy, fills up with fluid until lungs collapse
- not a lot of room for oxygenation
- air movement does not really occur/stuck
what is a VQ test
- measure their ventilation vs perfusion
- mismatch??
- detect PE, evaluate pulmonary function
describe the ventilation part of the VQ test
patient inhales a gas
see ventilation patterns
describe the perfusion (Q) part of the VQ test
contrast medium is injected and blood flow is visualized
what can interfere with a pulse ox reading
- Elevated bilirubin level may falsely lower readings
- IV lipids and dyes can interfere
- Excessive light, movement, ear pigment, hypothermia, hypotension and vasoconstriction
- Blue, green, black and brown nailpolish
what can falsely elevate a pulse ox reading
- Carboxyhemoglobin can falsely elevate readings
- anemic (d/t low RBC)
what is a normal SVO2
60-80%
what does a decreased SVO2 mean
decreased values, less than 60% may indicate increased oxygen usage by tissues or a decreased oxygen delivery
what does an increased SVO2 mean
SVO2 values greater than 80% may indicate tissue death in organs, as they do not pick up the oxygen
how is SVO2 measured
measured by a pulmonary artery catheter or a central line
*can also get off the ventilator
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Quiz 1 EKG30
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Quiz 1 Concepts27
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Quiz 1 Cardiac Practice46
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Shock 138
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Shock 235
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Shock 326
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Sepsis 130
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Sepsis 231
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Sepsis 340
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Burns 130
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Burns 238
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Burns 330
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ED Care34
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ED Care 228
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Burns 431
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Burns 527
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Cardiac Emergencies 134
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Cardiac Emergencies 234
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Cardiac Emergencies 329
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Cardiac Emergencies 421
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Respiratory 130
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Respiratory 232
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Respiratory 329
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Respiratory 429
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Respiratory 530
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Respiratory 624
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Neuro 133
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Neuro 235
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Neuro 318
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Neuro 436
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Neuro 537
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Neuro 644
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Renal 139
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Renal 231
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Renal 322
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GI 132
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GI 231
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Sickle Cell0
