Terms Definitions
Diffusion gradient - Area where highest CO2 is found
Chronic Bronchitis: PFT Findings
Expiratory Maneuver Findings:
What is the primary blood gas component maintained by acid-base balance
True or False: Potential complications associated with CPAP therapy usually include all of the following: barotrauma, hypoventilation, gastric distention, and hypercapnia
True,REF: 916
Hemoglobin saturation formula
SaO2 = [HbO2/total Hb] x 100
describe the process of compensation
in hypoventilation (respiratory acidosis) the kidneys restore the pH to normal by reabsorbing HCO3, compensatory renal response to hyperventilation (respiratory alkalosis) is urinary eliminatin of HCO3. if a metabolic process lowers or raises HCO3 the lungs compensate by hyperventilation (eliminating CO2) or hypoventilation (retaining CO2) restoring the pH to near normal
Given the following blood parameters, compute the total oxygen content (dissolved + HbO2) of the blood in ml/dl: Hb = 18; PO2 = 40 mm Hg; SO2 = 73%.
B) 17.7 ml/dl
True or False: Flow-oriented devices have proved less effective than volumetric systems.
False REF: 908
True or False: During administration of a continuous positive airway pressure flow mask to a patient the most common problem is system leaks or leaks around the mask.
True REF: 917
True or False: Incentive spirometry is considered bronchial hygiene therapy:
False,REF: 925
What is the normal value of the arterial oxygen content of combined O2 (1.34x 15 x SO2)
19.5 ml/dl
At body temperature, how much oxygen will physically dissolve in plasma at a PO2 of 40 mm Hg?
A) 0.12 ml/dl
When Hb saturation with oxygen is high, less carbon dioxide is carried in the blood. What is this relationship called?
D) Haldane effect
True or False: A patent airway, functional mucociliary escalator, and effective cough are all necessary for normal airway clearance.
True, REF: 922
True or False: The primary goal of bronchial hygiene therapy is to help mobilize and remove retained secretions.
True,REF: 924
Chronic Bronchitis: ABG Findings
Mild to Moderate Chronic Bronchitis: Decreased pHDecreased PaCO2Decreased HCO3- Decreased PaO2
What factors contribute to an increased in hemoglobin's (Hb) affinity for O2
acute alkalosis, decreased PCo2, Decreased temperature, low levels of 2,3 DPG, carboxyhemoglobin, methemoglobin, abnormal hemoglobin
How do the kidneys respond to hypoventilation and how to they respond to hyperventilation
hypoventilation by reabsorbing bicarbonate, hyperventilation by excreting bicarbonate
What is the most common cause of hypoxemia?
D) V/Q mismatch
All of the following drug categories can impair mucociliary clearance in intubated patients except: A. general anesthetics B. bronchodilators C. opiates D. narcotics
B,REF: 923 B. bronchodilators
True or False: The most likely cause of a postoperative patient using incentive spirometry and complaining of dizziness and numbness around the mouth after therapy sessions is gastric insufflation
False REF: 906
how do the lungs respond to metabolic acidosis, alkalosis
acidosis by hyperventilating, alkalosis hypoventilating
The affinity of Hb for carbon monoxide (CO) is approximately how many times greater than its affinity for oxygen?
D) 200 or greater
Explain the pulmonary diffusion gradients
For gas exchange to occur between the alveoli and pulmonary capillaries, a difference in partial pressures (P1-P2) must exist
What does hypokalemia do to the acid-base balance
forces the kidneys to excrete increased amounts of H+ to reabsorb Na+ causing alkalosis
What is the result of hemoglobin deficiency on oxygen delivery
hemoglogin carries the vast majority of oxygen, while blood plasma carries very little. if hemoglobin is unable to carry oxygen, the CaO2 will be greatly decreased and the patient will be hypoxic
Match the phase of a cough on the “right” with the mechanism responsible for impairing the cough on the “left”. Answers may be used once, more than once or not at all. 3. Tracheostomy tube
3. C C. Compression
Why is pulmonary gas exchange less than perfect
because of normal anatomic shunts and V/Q imbalances
Describe the V/Q ratio and cite its normal value
ventilation perfusion ratio; an ideal ratio of 1.0 indicates that ventilation and perfusion are in perfect balance. High V/Q indicates that ventilation is greater than normal, perfusion is less than normal or both. A low V/Q ratio means ventilation is less than normal perfusion is greater than normal, or both
According to the Fick principle, if oxygen consumption remains constant, an increase in cardiac output will manifest itself as which of the following?
A) Decrease in the CaO2 - CvO2
Under what conditions will the alveolar PACO2 rise above normal?
C) If VA decreases relative to carbon dioxide production.
Chest physical therapy can be expected to improve airway clearance when a patient’s sputum production exceeds _____________ml/day
D, REF: 925 D. 25 to 30
Which of the following is NOT a hazard or complication of postural drainage therapy?
D,REF: 926 D. pulmonary barotraumas
How is CO2 transported in the blood and what are the percentages of each
1) dissolved in plasma and erythrocyte intracellular fluid - 8%; 2)chemically combined with protein - 12%; 3) Ionized as bicarbonate -80%
Which of the following conditions alter normal mucociliary clearance? I. bronchodilation II. cystic fibrosis (CF) III. ciliary dyskinesia
D,REF: 924 D. II and III II. cystic fibrosis (CF) III. ciliary dyskinesia
Potential outcomes of IPB Therapy should include: I. Improved VC II. Improved oxygenation III. Improved breath sounds IV. Decreased secretion clearance and reduced cough mechanism
C,REF: 913 C. I, II, and III I. Improved VC II. Improved oxygenation III. Improved breath sounds
Which if the following is the only absolute contraindication to turning?
D. when the patient has unstable spinal cord injuries REF: 928
What is the P50 a partial pressure of
Oxygen at which the Hb is 50% saturated, standardized to a pH level of 7.4.
What occurs in the bases of the upright lung?
D) The V/Q is lower than the average.
What should the practitioner explain before starting an (IPPB) on a new patient? I. what the IPPB treatment will do II. why the physician ordered the treatment III. what the expected results are IV. how the IPPB treatment will feel
D,REF: 913 D. I, II, III, and IV I. what the IPPB treatment will do II. why the physician ordered the treatment III. what the expected results are IV. how the IPPB treatment will feel
In a person breathing room air (and with all else being normal), if the alveolar PCO2 rises from 40 to 70 mm Hg, what would you expect?
A) PAO2 to fall by about 30 mm Hg
Why is it necessary to keep the patient’s PaO2 greater than 60 mm Hg?
A) A level of 60 mm Hg marks the beginning of the steep part of O2Hb dissociation curve.
A 70-kg male patient has a VCO2 of 200 ml/min and a VA of 9 L/min. From this information, what can you infer?
C) The patient will have a lower than normal PACO2.
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