Oxygenation & Hypoxemia

Question 1

The goal is to maintain Oxygen saturation above

Answer 1

94%

Question 2

what is the arterial O2 tension (PaO2)

Answer 2

whats dissolved in the plasma & partial pressure

Question 3

What is the goal of PaO2?

Answer 3

Above 88mmHg

Question 4

What is the definition of A-a

Answer 4

The Big A- Alveolar
The small a- arterial

Question 5

How can the Alveolar-arterial oxygen gradient be increased?

Answer 5

by increasing FiO2

Question 6

An increase in Oxygen affinity, reduced oxygen delivery to tissues, alkalosis, low temperature, low DPG, and fetal Hb, causes a shift to the

Answer 6

LEFT

Question 7

An increase in oxygen delivery to tissues, reduced oxygen affinity, acidosis, increase in temperature and DPG, causes a shift to the

Answer 7

RIGHT

Question 8

Definition of Hypoxemia

Answer 8

Abnormally low O2 in the blood
General-whole body
Tissue-localized/regional

Question 9

How is hypoventilation corrected?

Answer 9

Increasing FiO2

Question 10

What happens with hypoventilation?

Answer 10

PaCO2 & PACO2 increase

PAO2 decreases

Question 11

Examples of LOW FLOW O2

Answer 11

Nasal Cannula, Simple Face Mask, Face Tent, Non-Rebreather Mask

Question 12

Examples of HIGH FLOW O2

Answer 12

High Flow Nasal Cannula, Venturi Mask, Nebulizer, Non-invasive and Invasive Mechanical Ventilation

Question 13

FiO2 delivery of the following Low Flow:
NC-
Simple Mask-
NRB-

Answer 13

NC-0.24-0.4
Simple Mask-0.35-0.55
NRB-0.80-0.95

Question 14

FiO2 delivery of the following High Flow:
Venturi-
Trach Collar-

Answer 14

Venturi-0.24-0.6
Trach Collar- (same)

Question 15

LPM:
NC-
Venturi-
Trach Collar-
Simple-
Non-rebreather

Answer 15

NC- 0.24-0.4
Venturi- 0.24-0.6
Trach Collar- (“ “)
Simple- 0.35-0.55
Non-rebreather- 0.80-0.95

Question 16

Preoxygenation replaces ____ with _____ being the second biggest resivoir of O2 besides the plasma

Answer 16

Replaces Nitrogen
FRC (Functional Residual Capacity)-denitrogenation

Question 17

Target end-tidal ETO2

Answer 17

90%

Question 18

Risk of delivering high O2 fraction

Answer 18

Hyperoxia

Hypotension (cause reduced SV & CO through increased SVR)

Cardiac & Cerebral ischemia (increased coronary constriction & decreased CBF)

Question 19

The airway is controlled by what autonomic system?

Answer 19

Parasympathetic (VAGUS nerve primary)

Question 20

Catecholamines binding to BETA-2 receptors in the airway smooth muscle will cause

Answer 20

BronchoDILATION

Question 21

Sympathetic NS and NANC control in airway

Answer 21

SNS-no DIRECT control

NANC-direct influence on smooth muscle (relaxation) and role in inflammatory response

Question 22

PSNS releases ______ which activates ______receptors, causing. vaso________

Answer 22

ACH; M3; constriction

Question 23

Activation of G____protein and ____________ & and an increase in _______ causes__________

Answer 23

Q; Phospholipase C; IP3; vasoconstriction

Question 24

What are some bronchoconstricting mediators released by the PSNS?

Answer 24

Bradykinin
Prostaglandins
Leukotrienes
Sub P
NK-A

Question 25

BETA-2 receptors on postganglionic cholinergic nerve causes

Answer 25

HYPER polarization & reduced ACh release

Question 26

BETA-2 recepotrs on airway smooth muscle calls cause

Answer 26

stimulation of adenyl cyclase which INCREASES cAMP, HYPERpolarizatioon, and ultimately smooth muscle relaxation

Question 27

HYPERpolarization is due to

Answer 27

loss of potassium

Question 28

Nitric OXide and Vasoactive Intestinal Peptide (VIP) are

Answer 28

Inhibitory

Question 29

Substance P and NK-A are

Answer 29

Stimulatory

Question 30

Asthma causes these changes in the respiratory system

Answer 30

Inflammation Irritability Remodeling Constriction Fibrosis Mucous production Smooth muscle hypertrophy Angiogenesis Increased vascular permeability

Question 31

Asthma causes ________airway resistance

Answer 31

Increased

Question 32

COPD is often ________

Answer 32

Irreversible

Question 33

Emphysema causes a loss of _________,__________, &____________

Answer 33

surface area, elastic recoil, & loss of structural integrity

Question 34

What can cause bronchoconstriction in the intra-op area

Answer 34

Abx, airway manipulation, surgical stimulation, NMB, histamine release(morphine)

Question 35

What are some assessment observations that will lead to a diagnosis of bronchospasm?

Answer 35

Increased Peak Airway Pressures, Reduced TV, difficulty bagging, sharkfin capnography, changes in SaO2 and PaCO2, wheezing

Question 36

Wheezing is

Answer 36

A POOR indicator of degree of airway obstruction