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Flight Paramedic Certification > Acid Base Balance and Oxygen Management > Flashcards

Acid Base Balance and Oxygen Management Flashcards

1
Q

FiO2

A

Fraction of inspired oxygen

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2
Q

PaO2

A

Partial arterial pressure of oxygen

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3
Q

PAO2

A

Partial pressure of alveolar oxygen

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4
Q

PvO2

A

Partial pressure of venous oxygen

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5
Q

Sao2

A

Arterial saturation of oxygen

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6
Q

Body’s preferred source of energy

A

Glucose

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7
Q

Aerobic Cellular metabolism

A

Glycolysis (2ATP) -> Pyruvic acid-> Acetyl coA -> Krebs cycle (2ATP) -> electron transport chain (34ATP)= 38 total ATP

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8
Q

What are the primary biproducts of Aerobic metabolism?

A

H2O and CO2

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9
Q

Anaerobic Cellular metabolism

A

Glycolysis (2ATP) -> Pyruvic acid -> Lactic acid

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10
Q

What is the primary biproduct of Anaerobic metabolism?

A

Lactic acid

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11
Q

What is shock?

A

Inadequate tissue oxygenation

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12
Q

Lactate levels

A

Normal = 0.5-1.5

>2.0 in ill patients signals lactic acidosis

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13
Q

Left shift of Oxyhemoglobin dissociation curve

A

Less hydrogen, holds on to oxygen instead.

Alkalosis

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14
Q

Causes of Left shift of Oxyhemoglobin dissociation curve

A

Low temp
Low 2-3DPG
Carbon Monoxide

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15
Q

Right shift of Oxyhemoglobin dissociation curve

A

Hydrogen rich environment.
Releases O2 quickly.
Acidosis

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16
Q

Causes of Right shift of Oxyhemoglobin dissociation curve

A

Raised acidosis
Raised temp
Raised 2-3 DPG
Reduced oxygenation

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17
Q

Carbonic acid - bicarbonate buffer system formula

A

Co2 + H20 = H2co3 (carbonic acid) = H+ / HCO3-

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18
Q

Fastest buffering system

A

Carbonic acid - bicarbonate buffering system work second to second in blood, lungs and kidneys but is easy to overwhelm.

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19
Q

Intermediate buffering system

A

Lungs adjust H2CO3 by blowing off or holding onto CO2.

Works Minute to Minute

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20
Q

Slow buffering system

A

Kidneys can reabsorb, create, or excrete HCO3- or H+.

Takes hours to days.

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21
Q

PaCO2 change of __ mmHg causes a Ph change of __ in opposite direction.

A

10 mmHg

0.08

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22
Q

Primary intracellular cation

A

Potassium

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23
Q

Primary extracellular cation

A

Sodium

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24
Q

For every change in Ph of __ , there is a change in Potassium of __ MEq/L in the opposite direction.

A
  1. 1

0. 6

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25
For every change in PaCO2 of __ mmHg, there is a change in Potassium of __ MEq/L in the opposite direction.
10 | 0.5
26
What causes a false high Potassium level?
Acidosis
27
What causes a false low Potassium level?
Alkalosis
28
Treatment of Hyperkalemia >5.5
Correct acid-base balance first Calcium chloride (raises action potential) NaHCO3 (Raises Ph, Moves K+ intracellular) D50/Insulin B2 agonist (albuterol) Lasix Kayexalate
29
Treatment Hypokalemia <3.5
Correct acid-base balance Do not exceed 0.5-1.0 MEq/kg/hr Normal is 10-20 MEq/hr
30
What is a normal Arterial Ph?
7.35-7.45
31
What is a normal PaCO2?
35-45
32
What is a normal Arterial HCO3-?
22-26
33
What is a normal PaO2?
80-100
34
What is a normal SaO2?
>95%
35
What is a normal BE (base excess)?
-2 to 2
36
ABG interpretation Ph 7.19 PCo2 66 HCO3- 24
Uncompensated respiratory acidosis
37
ABG interpretation Ph 7.27 PCo2 37 HCO3- 14
Uncompensated metabolic acidosis
38
ABG interpretation Ph 7.58 PCo2 14 HCO3- 22
Uncompensated respiratory alkalosis
39
ABG interpretation Ph 7.48 PCo2 41 HCO3- 30
Uncompensated metabolic alkalosis
40
ABG interpretation Ph 7.09 PCo2 60 HCO3- 14
Mixed disturbance (Both are causing issues)
41
ABG interpretation Ph 7.31 PCo2 68 HCO3- 34
Partially compensated respiratory acidosis
42
ABG interpretation Ph 7.17 PCo2 31 HCO3- 04
Partially compensated metabolic acidosis
43
ABG interpretation Ph 7.51 PCo2 29 HCO3- 37
Mixed disturbance
44
PaO2 should equal __ times Fio2
5
45
Formula for bicarb replacement
Kg/4 x Base deficit = MEq of bicarb needed
46
For every change in HCO3- of __ MEq, the Ph changes __ in the same direction.
10 | 0.15
47
Define Respiratory Acidosis
Failure to remove CO2 from plasma / lungs. | Ph <7.40, CO2> 45
48
Fast causes of Respiratory Acidosis
Failure to get CO2 to the lungs (decreased Cardiac Output). | Failure to get CO2 out of the lungs (decreased Minute Volume).
49
Slow causes of Respiratory Acidosis
Bronchospasm COPD V/Q mismatch (P.E., ARDS, Pneumonia) Pulmonary Edema
50
Treatment of Respiratory Acidosis
Remove CO2 by increasing alveolar minute volume
51
Define Respiratory Alkalosis
Alveolar hyperventilation causing removal of too much CO2. Ph >7.40 CO2 <35
52
Causes of hyperventilation
Tissue hypoxia secondary to poor supply Tissue hypoxia secondary to excessive demand Mechanical hyperventilation (most common) Anxiety
53
Treatment of Respiratory Alkalosis
Control anxiety | Decrease alveolar minute volume (decrease rate, then volume)
54
Define Metabolic Acidosis
Ph <7.40 HCO3- <22 Anion Gap >20
55
Normal Anion Gap
8-16 (w/o K+ factored) | 10-20 (with K+ factored)
56
Causes of Metabolic Acidosis
``` #1 Lactic Acidosis #2 DKA #3 Renal failure #4 Toxins ```
57
Primary toxin causing metabolic acidosis
Alcohols / Methanol / Ethylene Glycol
58
MUDPILES
``` Causes of Metabolic Acidosis Methanol (toxin) Uremia (renal failure) DKA Paraldehyde (toxin) Iron (toxin) Lactate Ethylene glycol (toxin) Salicylate (toxin) ```
59
Treatment of Metabolic Acidosis
Treat the cause! Lactic? Good oxygenation, improve cardiac output DKA? Control sugar, correct acidosis Renal failure? Identify treatable conditions Toxins? stop intake, look for antidote, supportive care
60
Metabolic Alkalosis
Too much HCO3 or too little H+ (hydrogen = acid) Ph >7.40 HCO3- >26 Worst of the Worst!
61
Causes of Metabolic Alkalosis
Think Electrolyte disorder! (#1 cause) GI loss of H+ (OG/NG suctioning, N/V) GI loss of electrolytes (diarrhea) Renal loss of potassium and hydrogen
62
Treatment of Metabolic Alkalosis
Identify and correct electrolyte abnormalities | Focus on Potassium, Magnesium, and Calcium

Flight Paramedic Certification (15 decks)

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