for the following scenarios, what happens to RR 1. exertion 2. hypoxia 3. hypercapnia 4. acidosis 5. CNS depression

1. normal increase 2. abnormal increase 3. abnormal increase 4. abnormal increase 5. abnormal decrease

Pulm Procedures Flashcards by Robert Kerby

what are the four cytologic and hematologic tests for pulm

blood work, nasal swab, saliva, and sputum to identify pathogens

How well did you know this?

Not at all

Perfectly

why use a cxr for lung patients

identify normal structures, identify lung fields, identify abnormalities

How well did you know this?

Not at all

Perfectly

what are three abnormally white lung fields

pneumonia, atelectasis, and pleural effusion

How well did you know this?

Not at all

Perfectly

what are two abnormally black lung fields

pneumothorax and COPD

How well did you know this?

Not at all

Perfectly

what is a normal V/Q ratio

0.8

How well did you know this?

Not at all

Perfectly

why use a V/Q scan

to rule OUT PE and other acute causes of dec O2 and gas exchange

How well did you know this?

Not at all

Perfectly

why is pulmonary angiography used? (3)

dx PE, dx AVM, and to dissolve a PE with thrombolytic agents

How well did you know this?

Not at all

Perfectly

what would you use to dx an acute PE: V/Q scan or pulm angiography?

pulm angiography

How well did you know this?

Not at all

Perfectly

what does flexible bronchoscopy do

direct visualization of the bronchial tree and dx/intervention to remove secretions and aspirated contents

How well did you know this?

Not at all

Perfectly

what is thoracentesis and pleural biopsy

inserting a needle into the pleural space to remove fluid or biopsy

How well did you know this?

Not at all

Perfectly

what is a PT implication for thoracentesis and pleural biopsy patients

postpone until post procedure cxr has ruled OUT pneumothorax

How well did you know this?

Not at all

Perfectly

what is oximetry

indirect assessment of oxyhemoglobin saturation (PO2)

How well did you know this?

Not at all

Perfectly

what does PFT determine

lung volumes and capacity
gas flow rates
gas diffusion

How well did you know this?

Not at all

Perfectly

how does PFT classify pulmonary diseases

obstructive
restrictive
combined

How well did you know this?

Not at all

Perfectly

What is tidal volume

amount of air inspired or exhaled during normal quiet breathing

How well did you know this?

Not at all

Perfectly

what is IRV

additional volume of air that can be taken in above normal Vt

How well did you know this?

Not at all

Perfectly

what is ERV

additional volume of air that can be forced about above normal Vt

How well did you know this?

Not at all

Perfectly

what is RV

residual volume of air still in the lung after forceful exhalation

How well did you know this?

Not at all

Perfectly

what is IC

inspiratory capacity of air that can be inhaled AFTER A TIDAL exhalation

How well did you know this?

Not at all

Perfectly

what is FRC

functional residual capacity of air remaining in the lungs AFTER A TIDAL exhalation

How well did you know this?

Not at all

Perfectly

what is VC

vital capacity - max volume of forceful exhale to max inhale

How well did you know this?

Not at all

Perfectly

what is TLC

max volume that the lungs can be expanded

How well did you know this?

Not at all

Perfectly

what is MV

minute ventilation - amount of air that is moved into or out of the lungs per minute

How well did you know this?

Not at all

Perfectly

for the following scenarios, what happens to RR

exertion
hypoxia
hypercapnia
acidosis
CNS depression

normal increase
abnormal increase
abnormal increase
abnormal increase
abnormal decrease

How well did you know this?

Not at all

Perfectly

Minute ventilation (Ve) is a product of ____ and ____

Vt and RR

what are the two results of hypoventilation

hypercapnia and respiratory acidosis

what are the two results of hyperventilation

ventilation hypocapnia and respiratory alkalosis

what is the difference between anatomic dead space (Vd) and alveolar dead space

Vd - airways that do not participate in gas exchange alveolar - alveoli that recieve too little blood supply and thus do not participate in gas exchange

how does FVC change in patients with obstructive disease

decreases

What is FEV1, what is normal, what is severe obstruction

forced expiratory volume in 1 second - normal is around 3 but severe obstruction is < 1.0

______ CO2 and _____ bicarbonate will make conditions more acidic

increase and dec

______ CO2 and _____ bicarbonate will make conditions more basic

decreased and increased

CO2 is regulated through which system

pulm system

Bicarb is regulated though which system

renal system

what is normal PO2

80-100

what is normal PCO2

35-45

what is normal pH

7.35-7.45

what is normal SaO2

97-100

what is normal HCO3

22-28

how long does it take for respiratory compensation to occur for primary metabolic disorder

begins in seconds

how long does it take for kidney compensation to occur for primary respiratory disorder

takes 12-24 hours

what are the two causes of acidosis

low bicarb (metabolic acidosis) and high PCO2 (respiratory acidosis)

what are the two causes of alkalosis

high bicarb (metabolic alkalosis) and low PCO2 (respiratory alkalosis)

PCO2 is an indicator of ventilatory status... what are the values and names of high and low PCO2

PCO2 < 30 = alveolar hyperventilation | PCO2 > 50 = alveolar hypoventilation and ventilatory failure

interpret the following values PCO2 > 45 and pH <7.40

respiratory acidosis

interpret the following values PCO2 > 45 and pH > 7.40

respiratory CO2 retention to compensate for metabolic alkalosis

interpret the following values PCO2 < 35 and pH > 7.40

respiratory alkalosis

interpret the following values PCO2 < 35 and pH < 7.40

respiratory CO2 elimination to compensate for metabolic acidosis

interpret the following values HCO3 < 22 and pH < 7.40

metabolic acidosis

interpret the following values HCO3 < 22 and pH > 7.40

renal compensation for respiratory alkalosis

interpret the following values HCO3 > 26 and pH > 7.40

metabolic alkalosis

interpret the following values HCO3 > 26 and pH < 7.40

renal compensation for respiratory acidosis

define mild hypoxemia

PO2 60-80 and SpO2 90-95%

define moderate hypoxemia

PO2 40-60 and SpO2 60-90%

define severe hypoxemia

PO2 < 40 and SpO2 < or = 60%

how does FiO2 change per liter of NC delivery

1 L = 0.24, then each liter adds 0.04 up to 6 liters = 0.44

what is the range of a simple face mask

5-10 L and 0.35 - 0.55 FiO2

what is the range of a NRB

>10 L and 0.6 - 0.8 FiO2

in patients with a history of lung disease, a drop in O2 sat to less than ___% during activity indicates that the patient needs additional oxygen

how does an invasive mechanical vent work?

artificial airway plus positive pressure to increase alveolar ventilation and reduce work of breathing

vents control OXYGENATION PO2 >60 by manipulate which two values

FiO2 and PEEP

what is PEEP

threshold-like resistance at the end of exhalation to prevent early closure of the distal airways and alveoli

vents control VENTILATION pH and PCO2 by manipulating which two values

TV and RR

what is a "mandatory" mode of ventilation

started, controlled, and ended by vent

what is a "assisted" mode of ventilation

started by the patient, but controlled and ended by the vent

what is a "spontaneous" mode of ventilation

started, controlled, and ended by the patient

what is controlled mandatory ventilation (CMV)

every breath is mandatory and RR and TV are set to deliver a minimum minute ventilation

what is a synchronized intermittent mandatory ventilation (SIMV)

the vent senses a pt's breath and delivers a mandatory breath, but it provides a mandatory breath even if the patient does not provide inspiratory effort.

what is CPAP

pt initiates and completes each breath with vent assistance via constant level of pressure both at inspiration and exhalation

what is positive pressure support or positive support ventilation

mode that provides positive pressure at each inspiration to help keep the airways open

what are two treatment implications for patients on vents

1. consider PROM or AROM of the neck and shoulder on the same side as the vent 2. transfers, standing, marching in place, and ambulation ARE encouraged

what should you know about suctioning (mostly done by respiratory therapy)

1. only clears the trachea and main bronchi 2. limit to 15-20 second bouts cuz it can cause hypoxemia 3. can cause atelectasis