M4 Flashcards by pink popcorn

a machine that can measure the oxygen-carrying
capacity of Hb in a specimen. It directly measures all the Hb species in the blood.

Co-oximeter or blood gas analyzer

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Co-oximeter or ___

blood gas analyzer

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The sample injected into the blood gas analyzer is pumped/pushed
into the ____

measuring cuvette.

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Once the whole blood is in the cuvette, the RBCs are _____

hemolyzed

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____, present in the reagent, is used to lyze RBCs.

Acid

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The co-oximetry test is ___the measurement of

after , oxygen saturation

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reduced form of Hb

HHb

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product of the binding/complexing of oxygen to Hb

O2hb

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together comprise less than 2-3% of total Hb

dyshemoglobins

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2 types of dyshemoglobins

Methb and Cohb

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methemoglobin in the form of ____

metalloprotein.

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Iron (Hb)

ferrous state

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Iron (MetHb)

Ferric state

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occurs if there is chronic or longterm
exposure/accumulation of drugs containing sulfur or chemicals such as
hydrogen sulfide

SulfHb

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Hb leaving the lungs & throughout the arteries

95-98% O2Hb, 2-
5%HHb

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 Hb leaving the capillaries and throughout the vein (after delivery of
oxygen)

70% O2Hb, 30%
HHb

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 Hb leaving the capillaries and throughout the vein (after delivery of
oxygen)

70% O2Hb, 30%
HHb

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 control sequencing of multiple wavelengths of lights hat passes
through the sample

Microprocessors

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Measures O2 saturation levels along with heart (pulse) rate

PULSE OXIMETER

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 reflect patient’s true status value.

Measured O2Hb

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 The absorption of light is____L to the amount of blood between
the microprocessor/electronic processor/transmitter and photodetector/photocell.

DIRECTLY PROPORTIONAL

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other name for microprocessor

electronic processor/transmitter

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other name for photodetector

photocell.

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The percentage of oxygen saturation measured by the pulse oximeter in healthy
individuals is between ___

95-100%

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These sensors compare how much___ and ___is absorbed by the blood.

red light and infrared light

red light

660 nm

infrared

940 nm

The measurement of oxygen-carrying capacity of the blood is through ___

spectrophotometry

red diode

reduced Hb

infrared

oxyhb

 Deoxygenated blood

= reduced hemoglobin = more absorption and sensor on red light diode

Oxygenated blood =

absorption is on infrared light or region

___ are also used in electrophoresis

 Electrodes

 The purpose of the two electrodes is to serve as sensing device (sensors) to measure ___

partial oxygen pressure (pO2), pCO2, and pH.

 Negatively-charged electrode.  Purpose: site at which reduction occurs.  Cations move toward this.

Cathode

Potentiometric:

pCO2 and pH

Amperometric:

pO2

 Positively-charged electrode.  Purpose: Site where oxidation occurs.  Anions move/flow toward the anode.

Anode

____ is formed when there are two opposite electrodes immersed in a liquid. The liquid serves as the conductor of the current.

Electrochemical cell

Reference electrode : pH

 Calomel [Hg-HgCl] - used because it is less toxic.  Ag-AgCl half-cell

 Measures hydrogen ions

Kept from protein buildup. Since proteins are negatively charged, they can cause error in reading.

modified pH electrode

Severinghaus electrode

 Located at the tip of the Clark electrode.  Purpose: it filters/selectively chooses/allows the oxygen to diffuse into the electrolyte and to contact the cathode

Gas permeable membrane covering

Typically, ____ V is applied between the anode and cathode. There is a need to apply this voltage so that there will be movement of oxygen.

-0.65

 Placed between the anode and cathode.

Microammeter

Purpose: measures the movement of electrons (measures the amount of electric current)

Microammeter

 Purpose: gives us the ability to continuously measure the amount of pO2. This is allowed to come in contact with the individual’s skin.

TC electrodes

used since beginning (of the clinical measurement of blood gases)  There have been modifications to simplify the test, their use, and to minimize the required sample volume and maintenance

Macroelectrodes

miniature macroelectrodes - only a small sample will be required.

Microelectrodes

 Sensors are reduced to tiny wires embedded in a printed circuit card

Thick and Thin Film Technology

Purpose of modification:

to reduce required sample volume

o Special card has ____ to separate the components.

etched grooves

The special paste material is ____ the sensor while the special card is only located ___

spread over,at one end.

Advantages of thick and thin film technology:

1. Disposable 2. Less expensive 3. Less maintenance

 Certain fluorescent dyes → react predictably with specific chemicals___

(O2, CO2, H)

 Certain fluorescent dyes → react predictably with specific chemicals (O2, CO2, H)

Optical Sensors

 Separated from the sample by a membrane: ___

INCREASE or QUENCHING of fluorescence

Quenching is any process wherein the fluorescent intensity ____

decreases.

Primary purpose of measurement is to _____

assess oxygen transport from the lungs

Stabilize ___ status prior to blood sample collection

patient’s ventilation

Cells consume oxygen. If analysis is prolonged/ delayed, O2 saturation results will falsely decrease.

 Analyze ASAP -

The angle for venipuncture is 15-30 degrees. For arterial puncture, the angle is almost at ____because arteries are located deeper than the veins.

45 degrees

Choice of site

Radial artery Brachial artery Femoral artery Temporal artery

Arterial Samples

pH and blood gas studies

Peripheral venous samples

pulmonary function or O2 transport is not being assessed

Capillary blood

pH and pCO2

This is permanent while the patient is admitted.

Indwelling arterial line

__: open the line, collect few mL of blood, discard, the next blood collected is used as sample for blood gas analysis

Flushing procedure

If storage is unavoidable, store the sample at room temperature for ___ (if plastic syringe) - Avoid cooling of samples when kept in plastic

maximum of 30 minutes

____ is more recommended since if liquid heparin was used and was excessive, it can dilute the sample

 Dried/lyophilized

The blood supply to hand normally comes from two arteries: the radial artery and the ulnar artery. Before drawing blood for an arterial blood gas test, make sure that both arteries are open and working correctly.

ALLEN’S TEST

Locate the patient’s ulnar and radial arteries. Ask the patient to make a tight fist for about ___

30 seconds.

Obstruct the blood flow by pressing down on the ____using the two fingers of each hand.

ulnar and radial arteries at the same time

Tell the patient to unclench the fist. The color of palm should be ____ because there is no blood flow towards that area. If the color is red, the obstructing of the two arteries was unsuccessful. Repeat from the start

bluish

 The pKa of the bicarbonate buffer system at body temperature is 6.1.

HCO3-

ctCO2 (total CO2 content)

bicarbonate + dCO2 + associated CO2

 to assess the non-respiratory component of a patient’s acid-base disorder

base excess

due to excess of bicarbonate or a relative deficit of non-carbonic acid; suggestive of non-respiratory ALKALOSIS

Positive value

due to excess of non-carbonic acid or a relative deficit of bicarbonate; suggestive of non-respiratory ACIDOSIS

Negative value

pH 7.35-7.45

pCO2

35-45 mmHg

pO2

80-100 mmHg

HCO3-

22-26 mEq/L

M4 Flashcards

(84 cards)