RES149 Flashcards

Hemoglobin
Terms Definitions
What is PAO2
partial pressure of oxygen
True or False: Irritation, inspiration, compression, and expulsion are all part of the normal cough reflex.
True,REF: 922
Calculate the hemoglobin saturation where HbO2 of 15 g/dl Hb of which 7.5g was HbO2
Sao2 = [7.5/15]x100=50%
Decreased or Normal: IC and ERV
Decreased: VC
How is alveolar PO2 computed
using alveolar air equation
What does V/Q mismatch have the biggest impact on?
C) Oxygenation
True or False: The semi-fowler’s position is ideal for the patient receiving an intermittent positive-pressure breathing treatment.
True REF: 914
True or False: When assessing the potential need for postoperative bronchial hygiene for a patient, considering the number of prior surgeries is very relevant.
False,REF: 925
____________________ is the most physiologic form of lung expansion therapy.
Incentive spirometry REF: 905
Define anemic hypoxia
when the blood cannot carry enough oxygen, even when enough O2 gets from the lungs to the blood
In which of the following conditions will erythrocyte concentration of 2,3-DPG be decreased?
B) Banked blood
The lowest PO2 would normally be found in what location?
C) Cells
A patient has a whole-body oxygen consumption of 320 ml/min and a measured CaO2 - Cv O2 of 8 ml/dl. What is the cardiac output?
B) 4.0 L/min
True or False: Anesthesia can provoke a cough?
False REF: 922-923
What is the normal value for PO2 of venous blood returning to the lungs from the right side of the heart
40 mmHg
What is the normal value of the venous oxygen content of dissloved O2
0.1 ml/dl
What is the normal value of the total venous oxygen content
14.8 ml/dl
The expected PaO2 for an 80-year-old man who is otherwise in good health and breathing room air is about what level?
B) 75 mm Hg
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. ____2. Anesthesia
A. Irritation
True or False: All of the following factors are responsible for making an IPPB device cycle off prematurely? I. airflow obstructed II. kinked tubing III. occluded mouthpiece IV. active resistance to inhalation
True, REF: 915
WHat are the two ways metabolic acidosis occurs
fixed (nonvolatile) acid accumulation in the blood or an excessive loss of HCO3 from the body
Primary objectives for turning include all of the following except to:
A,REF: 928 A. prevent postural hypotension
What factors contribute to a decrease in hemoglobin's (Hb) affinity for O2
Acute acidosis, High CO2, Increased temperature, high levels of 2,3 DPG, abnormal hemoglobin
what regulates the volatile acid content of the blood (CO2) whereas what controls the fixed acid concentration of the blood
the lungs regulate the volatile acid content of the blood (CO2) whereas the kidneys control the fixed acid concentration of the blood
What does the alveolar PCO2 vary directly with and inversely with
varies directly with carbon dioxide production and inversely with alveolar ventilation
Which of the following conditions must exist for gas to move between the alveolus and pulmonary capillary?
B) Difference in partial pressures (pressure gradient)
Which of the following is NOT a potential contraindication for intermittent positive-pressure breathing?
A. neuromuscular disorders A,REF: 912
WHat are normal blood gas ranges
pH 7.35-7.45; PaCO2 35 - 45 torr; HCO3- 22-25 mEq/L; PaO2 80-100 torr
What conditions cause the HbO2 curve to the left
conditions that cause an increase in Hb affinity for oxygen
Which of the following equations best describes oxygen delivery to the tissues?
B) arterial oxygen content x cardiac output
Which of the following hyperinflation techniques relies on the patient’s ventilatorymuscles to achieve hyperinflation goals?
D. II and IV II. incentive spirometry IV. positive expiratory pressure (PEP) therapy
What postural drainage position would you recommend if a patient’s chest radiograph shows infiltrates in the posterior basal segments of the lower lobes?
Head down (foot of bed elevated 18 inches), patient prone with a pillow under abdomen REF: 930 Figure 40-3.
In disease, what is the range of V/Q ratio
ranges from zero (perfusion without ventilation or physiologic shunting) to infinity (pure alveolar dead space)
What must be in balance for pulmonary gas exchange to be effective
ventilation and perfusion must be in balance
How much faster does Carbon dioxide diffuse across the alveolar-capillary membrane than does oxygen and why
20 times faster, because of its much higher solubility in plasma
The oxidation of the Hb molecule’s iron ions to the ferric state (Fe3+) results in which of the following?
C) II and III II. Formation of methemoglobin (metHb). III. Inability of metHb to bind with oxygen.
Which of the following are contraindications for continuous positive airway pressure (CPAP) therapy? I. hemodynamic instability II. hypoventilation III. facial trauma IV. low intracranial pressures
C,REF: 916 C. I, II, and III I. hemodynamic instability II. hypoventilation III. facial trauma
What is Fick Formula for calculating Cardiac Output (both Qt and C.O.)
Qt = VO2 / [C (a-v) O2 x 10]
Which of the following would you expect to find with “oxygen debt”?
B) I and II I. Accentuated in diseases such as sepsis. II. Oxygen demand exceeds oxygen delivery.
What role does the Bohr effect play in oxygen transport?
C) Enhances oxygen delivery to tissues and oxygen pickup at lungs.
Key considerations in initial and ongoing patient assessment for chest physical therapy include which of the following? I. posture and muscle tone II. breathing pattern and ability to cough III. sputum production IV. cardiovascular stability
C. I, II, III, and IV REF: 925 I. posture and muscle tone II. breathing pattern and ability to cough III. sputum production IV. cardiovascular stability
compare CO affinity to Hb compared to O2
CO is more than 200 times greater than it is for oxygen. Even extremely low concentrations of CO represent a loss in carrying capacity. CO with Hb shifts the HbO2 curve to the left furhter impeding oxygen delivery.
In which of the following patients would you consider modifying any head-down positions used for postural drainage?
I, II, III, and IV REF: 929 I. a patient with unstable blood pressure II. a patient with a cerebrovascular disorder III. a patient with systemic hypertension IV. a patient with orthopnea
Calculate the following using Fick Formula for cardiac output; factor of 10 converts ml/dl to ml/L. Given a normal VO2 of 250 ml/min and a normal C (a-v)O2 of 5 ml/dl
Qt = 200 ml/min/ (5 ml/dl x 10) ; Qt = 250 ml/min / 5 ml/dl; AT = 5.0 L/min
Which of the following are appropriate volume goals for intermittent positive-pressure breathing (IPPB) therapy? I. 10 to 15 ml/kg ideal body weight II. at least 30% of the inspiratory capacity (IC)
B,REF: 914 B. I and II I. 10 to 15 ml/kg ideal body weight II. at least 30% of the inspiratory capacity (IC)
An area of the lung has no ventilation but is normally perfused by the pulmonary circulation. Which of the following statements are correct?
D) I, II, and III I. Blood exiting the pulmonary capillary will have a PO2 = 40 and a PCO2 = 46. II. The area represents an alveolar shunt. III. The V/Q is 0.
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