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CR2 > Respiratiry Failure > Flashcards

Respiratiry Failure Flashcards

1
Q

What are the 4 stages of the oxygen cascade

A

Inspired gas - PiO2
Alveolar gas - PAO2
Arterial blood - PaO2
Cell - PO2

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2
Q

What kind of gas exchange occurs in the lungs

A

Passive diffusion

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3
Q

What factors effect alveolar PO2

A

Alveolar ventilation
Oxygen consumption
CO2 production

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4
Q

What determines the alveolar to arterial PO2 difference

A

Shunting

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5
Q

How is normal PaO2 calculated

A

13.6 - (0.044 x age in yrs) kPa

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6
Q

Shunting

A

Areas of the lung that are perfused but not ventilated

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7
Q

Factors increasing oxygen transport in blood

A

Low pH
Incr temp
More 2,3-DPG
incr CO2

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8
Q

What is the difference between type 1 and type 2 respiratory failure

A

Type 1 just hypoxaemia
Type 2 hypoxaemia and hypercapnic

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9
Q

What O2 and CO2 arterial partial pressures show type 1 respiratory failure

A

O2 - <8.0kPa
CO2 - normal

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10
Q

What o2 and CO2 arterial partial pressures show type 2 respiratory failure

A

O2 - <8kPa
CO2 - >6kPa

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11
Q

What type of respiratory failure is caused by lung failure

A

Type 1

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12
Q

What type of respiratory failure is caused by pump failure

A

Type 2

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13
Q

5 pathophysiological mechanisms of hypoxaemia

A

Ventilation perfusion mismatch
Anatomical R-L shunt
Impaired diffusion
Alveolar hypoventilation
Low partial pressure of inspired o2

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14
Q

Reasons for hypoventilation

A

Increased resistance due to airway obstruction
Reduced compliance of lung tissue or chest wall
Reduced strength of resp muscles
Drugs reducing overall ventilation

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15
Q

Signs of respiratory failure

A

Tachypnoea
Use of accessory muscles
Nasal flaring
Intercostal recession
Suprasternal recessiom
Tachycardia
Hypertension
Sweating
End organ hypoxia
Cyanosis
Asterixis
Bounding pulse

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16
Q

What causes asterixis and bounding pulse

A

CO2 retention

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17
Q

How does respiratory failure affect sympathetic tone

A

Increase

18
Q

First line respiratory failure investigations

A

Physical exam
Pulse oximetry
ARterial blood gas
Chest x ray

19
Q

Can pulse oximetry be used to assess ventilation

A

No

20
Q

Sourced of error in pulse oximetry

A

Poor peripheral perfusion
Dark pigmented skin
False nails/nail varnish
Lipaemia/hyperlipidaemia/protocol infusion
Bright ambient light
Poorly adherent probe
Excessive motion

21
Q

Do oximeters over or under read on patients with dark pigmented skin

A

Over read

22
Q

What is normal blood pH

A

7.35-7.45

23
Q

What is acidotic blood pH

A

<7.35

24
Q

What is alkalosis blood pH

A

> 7.45

25
Q

What 2 mechanisms drive blood pH

A

Respiratory
Metabolic

26
Q

How can metabolic acidosis and respiratory acidosis be told apart

A

Metabolic - low HCO3
Respiratory - high CO2

27
Q

How can respiratory and metabolic alkalosis be told apart

A

Metabolic - high HCO3
Respiratory - low CO2

28
Q

Is HCO3 normal in respiratory or metabolic acidosis/alkalosis

A

Respiratory

29
Q

Is PaCO2 normal in respiratory or metabolic alkalosis

A

Metabolic

30
Q

Compensation

A

Body tries to adjust other buffers to keep pH normal

31
Q

What is normally the SpO2 target for patients receiving supplemental O2

A

94-98%

32
Q

What is the first line treatment for respiratory failure

A

Oxygen

33
Q

4 oxygen delivery systems

A

Nasal cannula
Simple face mask
Non rebreather mask
Venturi mask

34
Q

Which masks could be used for a patient with normal vital signs

A

Nasal cannula, simple face mask

35
Q

Which mask could be used when a high O2 concentration is needed

A

Non rebreather mask

36
Q

Which face mask could be used for controlled treatment in long term respiratory failure

A

Venturi mask

37
Q

What are the different colours of Venturi masks from low to high flow rate + oxygen delivery

A

Blue
White
Yellow
Red
Green

38
Q

What needs to be monitored during oxygen therapy

A

Vital signs
Arterial blood gas

39
Q

How is hypercapnia treated

A

Ventilation

40
Q

What sO2 should be aimed for in CO2 retainers

A

90-92%
May need 85+

CR2 (33 decks)

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