Comp Review

  1. Causes of increased respiratory rate
    hyperthermia, fever, acidosis, hypoxemia, anxiety, pain
  2. Causes of decreased respiratory rate.
    hypothermia, alkalosis, hyperoxia
  3. Components of BP
    contractility of LV, arterial resistance, blood volume
  4. Normal child BP
  5. Signs of hypokalemia
    cardiac rhythm disturbances, muscle weakness
  6. ECG changes in hypokalemia
    flat or inverted T waves, depression of ST segments, PVCs, V Fib
  7. ECG changes in hyperchloremia
    prolongation of ST segment & QT interval
  8. ECG changes in hyperkalemia
    high, peaked T waves, depressed ST segments, wide QRS complexes, bradycardia
  9. ECG changes in hypochloremia
    shortened QT interval, widened and rounded T waves
  10. Normal adult chloride level
    95-106 mEq/L
  11. Normal adult Potassium level
    3.5-5.5 mEq/L
  12. Normal adult sodium level
    135-145 mEq/L
  13. Normal adult calcium level
    4.5-5.5 mEq/L
  14. Normal adult bicarb level
    23-25 mEq/L
  15. Normal adult serum glucose level
    70-110 mg/100 mL
  16. Creatine Kinase (CK-MB)
    cardiac enzyme, increases 4-6 hours after MI
  17. Troponin I (cTnI)
    cardiac enzyme, increases 2-4 hours after MI
  18. Troponin T (cTnT)
    cardiac enzyme, increases 2-4 hours after MI
  19. Brain natriuretic peptide (BNP)
    cardiac enzyme, elevated in pt with CHF
  20. C-reactive protein
    non specific enzyme, marker of inflammation linked to risk for MI, stroke & PV disease
  21. Normal adult Hemoglobin level
    13.5-18.0 g/100 mL
  22. Normal adult Hematocrit level
  23. Normal adult RBC level
    4.6-6.2 million/mL
  24. Leukocytosis
    elevated WBC, signals bacterial infection
  25. Increased Neutrophils indicates:
    acute, severe bacterial infection
  26. Normal adult WBC level
    4500-11000 mm3
  27. Leukopenia
    low (3000-5000/mm3, suggests acute viral infection
  28. Normal adult PT level
    11-12.5 seconds
  29. Normal adult PTT level
    60-70 seconds
  30. Normal adult APTT level
    30-40 seconds
  31. The most common types of bacteria that cause bronchitis and pneumonia are:
  32. Clinical S&S of dehydration
    tachycardia, hypotension, high urine specific gravity, oliguria, low CVP, low PCWP, poor skin turgor, slow capillary refill, mental confusion
  33. Clinical S&S of fluid overload
    tachycardia, hypertension, low urine specific gravity, increased urine output, increased CVP, increased PWCP, peripheral edema, pulmonary edema (crackles/rales)
  34. Normal adult ICP level
    <10 mm Hg
  35. Indications for CXR
    significant change in CP condition, following invasive thoracic procedure, hemoptysis, suspected pulmonary infarct, suspected pneumothorax
  36. Clinical S&S of pneumothorax
    sudden chest pain, SOB, absent breath sounds over a lung field, tracheal deviation, shifted heart sounds, assymterical chest movement, hyperresonant percussion over the pneumothorax, sudden increase in peak or plateau pressure, sub-Q emphysema
  37. Indications for upper airway radiograph
    suspected FB aspiration, laryngeal edema, laryngeal tumor, laryngotrachealbronchitis, epiglottitis
  38. Indications for CT Scan
    tumor, hematoma, abscess/cyst, aortic or vascular abnormality, trauma, FB
  39. Indications for MRI
    imaging of head, spinal cord, heart, great vessels, kidneys, liver, other organs
  40. Indications for PET Scan
    determining regional metabolism of heart or brain, measuring the size of an MI. measuring the effects of rx on a cancerous tumor, determining pulmonary perfusion or ventilation
  41. Indications for V/Q Scan
    suspected pulmonary embolism or airway obstruction
  42. Quality of CXR
    proper positioning, exposure
  43. PA CXR
    standard view, accurate heart size, deep breath
  44. AP CXR
    heart size appears larger than actual
  45. Lateral CXR
    visualize behind heart & hemidiaphragms, localize lesions, measure AP diameter
  46. Oblique CXR
    check heart borders, mediastinal structures, hilar structures & lung masses
  47. Lateral Decubitus CXR
    allows visualization of fluid in pleural spaces or pulmonary cysts
  48. Dorsal Decubitus CXR
    id small pneumothorax in an infant
  49. Lordotic CXR
    visualization of upper lung fields
  50. Radiopaque items
    dense, absorb more radiation, appear white
  51. Radiolucent items
    have little density, absorb less radiation, appear darker
  52. Mediastinal shift toward
    atelectasis or pulmonary fibrosis
  53. Mediastinal shift away
    tension pneumothorax
  54. Unilateral elevation of hemidiaphragm
    atelectasis, pulmonary fibrosis, hepatomegaly
  55. Normal adult CT Ratio
  56. Blunt costophrenic angles
    pleural effusion
  57. Meniscus Sign
    pleural effusion
  58. CXR indications of pulmonary edema
    fluffy white infiltrates in one or both lung fields, more common in LL, great vessels may also be englarged
  59. CXR indications of consolidation
    dense white shadows, air bornchograms may be visible
  60. Diaphoresis at rest is indicative of:
    shock or hypoxemia
  61. Eupnea
    normal respiratory pattern
  62. Tactile fremitus
    conditions that increase density result in more intense vibrations
  63. Rhonchial fremitus
    vibrations from airway secretions
  64. Increased unilateral tactile fremitus
    pneumonia, atelectasis, consolidation
  65. decreased unilateral tactile fremitus
    pneumothorax, pleural effusion, bronchial obstruction
  66. increased bilateral tactile fremitus
    pulmonary edema, ARDS
  67. decreased bilateral tactile fremitus
    thick chest wall, COPD
  68. Glasgow Coma Scale
    0-15, 15 being normally awake/alert and 0 being nonresponsive
  69. Hypopnea
    shallow breathing
  70. bradypnea
    slow breathing
  71. tachypnea
    rapid breathing
  72. obstructed inspiration
    croup, epiglottitis, FB, laryngeal edema, airway trauma
  73. obstructed expiration
    asthma, COPD, CF, airway tumor, trauma
  74. Kussmaul respirations
    rapid deep breaths, usually secondary to acidosis (eso. diabetes)
  75. Cheyne-Stokes respirations
    waxing and waning breaths with periods of apnea: head injury, stroke, high ICP, CHF
  76. Biot's respirations
    variable depth and frequency of respirations with periods of apnea: meningitis,brain injury, brain tumor, increased ICP
  77. Huff Cough
    mid-inspiratory cough
  78. Airborne Precautions
    Negative pressure room, gloves, handwashing NIOSH-approved mask (N95), eye protection: TB, varicella, rubeola, H1N1, SARS
  79. Droplet Precautions
    in addition to Standard Precautions: private or cohort room, isolation mask; haemophilus influenza type b, meningitis, myco[lasma pneumoniae, bordetella pertussis
  80. Contact Precautions
    In addition to standard precuations: private.cohort room, gloves, gown, dedicated equipment:C. difficile, MRSA, respiratory syncytial virus, herpes zoster
  81. Pneumovax 23
    provides protection against 23 most prevalent or invasive types strep pneumoniae bacteria.
  82. Influenza
    seasonal, protection against three strains of virus
  83. Blood spills must be cleaned up with:
    chlorine compound (bleach)
  84. Home equipment can be cleaned with:
    1.25% solution of acetic acid (vinegar) - soak 60 minutes
  85. Indications for hemoximetry and Co Oximetry
    determine the presence & quantity of dyshemoglobins such as carboxyhemoglobin and methemoglobin
  86. Indications for mixed venous oxygen pressure monitoring
    calculate a patient's oxygen carrying capacity
  87. Indications for capillary blood gas analysis
    estimate the acid-base balance and adequacy of ventilation: should not be used to estimate oxygenation
  88. Indications for venous blood gases
    evaluate pH in patients with uremia or diabetic ketoacidosis
  89. Effect of air bubble in blood gas sample
    measured oxygen would be inaccurately higher and measured carbon dioxide level would be inaccurately lower: pH would be inaccurately high
  90. Effect of excessive heparin in a blood gas syringe
    reduce the pH and pCO2 and increase the O2 level
  91. After an Allen test, hand should flush within ___ seconds.
  92. For a neonatal heel stick, the heel should be heated for 5-10 minutes to a temperature of ____?
    42 degrees C
  93. The pH electrode is a _____ electrode.
  94. The pCO2 electrode is a ______ electrode.
  95. The pO2 electrode is a ______ electrode.
  96. The partial pressure of oxygen in the blood come from ______?
    the oxygen that is dissolved in the plasma and not from the oxygen bound to the hemoglobin
  97. Accuracy/Precision in an analyzer means?
    that the measured physiologic values truly reflect the actual physiologic values
  98. Reliability in an analyzer means?
    that a high degree of confidence exists that the measured values represent the patient's actual physiologic values
  99. Quality Assurance (in an analyzer) means?
    the results are not only accurate and reliable but also are clinically useful
  100. The predicted pCO2 value at a given CO2 percentage is calculated?
    pCO2 = (Pb - P H2O) x % CO2, where Pb = barometric pressure and pH2O is water vapor pressure
  101. The predicted pO2 value at a given O2 percentage is:
    pO2 = (Pb - PH2O) x % O2
  102. Blood gas analyzers are calculated at what temperature?
    37 degrees C; if the patient is febrile, the PCO2 and pO2 will be greater than measured; if hypothermic, the actual values will be lower
  103. What does a hemoximeter measure?
    oxyhemoglobin, carboxyhemoglobin, methemoglobin and reduced hemoglobin
  104. What is the effect of imaging dyes on oxymetry?
    they may absorb the same wavelengths and report inaccurately lower oxygemoglobin than is actually present
  105. What is the effect of lipids in oxymetry?
    the presence of lipids causes total hemoglobin readings that are falsely high and falsely low measurements of oxyhemoglobin and carboxyhemoglobin.
  106. Acceptable pO2 range in newborn
    40-70 torr
  107. Acceptable pO2 range in children & adults
    >80 torr
  108. Mild Hypoxemia on RA
    • paO2 60-79 torr
    • SaO2 90-94%
  109. Moderate Hypoxemia on RA
    • paO2 40-59 torr
    • SaO2 75-89%
  110. Severe Hypoxemia on RA
    • paO2 < 40 torr
    • SaO2 <75%
  111. Bicarb levels indicating metabolic alkalosis
    HCO3 > 24 mEq/L or BE > 1
  112. Bicarb levels indicating metabolic acidosis
    HCO3 < 24 mEq/L or BE <-1
  113. PaCO2 > 45 torr indicates
    respiratory acidosis, alveolar hypoventilation, ventilatory failure
  114. pH < 7.35 indicates
  115. PaCO2 < 35 torr indicates
    respiratory alkalosis, alveolar hyperventilation
  116. pH > 7.45 indicates
  117. PaCO2 > 45 torr and pH < 7.35 indicates
    acute ventilatory failure
  118. PaCO2 > 45 torr and pH 7.35-7.40 indicates
    chronic ventilatory failure
  119. pH > 7.50, PaCO2 35-45 torr
    Metabolic alkalosis
  120. pH < 7.30, PaCO2, PaCO2 35-45 torr
    metabolic acidosis
  121. pH > 7.50, pCO2 > 45 torr
    partially compensated metabolic alkalosis
  122. pH 7.30-7.40, PaCO2 > 45 torr
    chronic ventilatory failure
  123. pH < 7.30, PaCO2 > 45 torr
    acute ventilatory failure
  124. pH > 7.50, PaCO2 < 35 torr
    acute alveolar hyperventilation
  125. pH 7.40-7.50, PaCO2 < 35
    chronic alveolar hyperventilation
  126. pH 7.30-7.40, PaCO2 < 35 torr
    compensated metabolic acidosis
  127. pH < 7.30, PaCO2 <35 torr
    partially compensated metabolic acidosis
  128. Normal Total Hemoglobin levels
    15.0 g/dL
  129. Normal oxyhemoglobin as % of total Hbg
  130. Normal carboxyhemoglobin as % of total Hbg (non smoker)
  131. Normal methemoglobin as % of total Hbg
    0.5 - 3%
  132. Normal arterial oxygen content
    15-23 g/dL
  133. Mixed Venous Blood Gas
    Taken from PA via Swan Ganz: reveals what has happened to arterial blood as it passes through the body: reflects oxygen consumption and cardiac output
  134. Tissue hypoxemia
    Mixed venous pO2 < 30 or mixed venous sat of <56
  135. Normal SpO2
  136. Indications for pulse oximetry
    during procedures, postop, when patient is sedated, during sleep studies, during periods of respiratory distress, to evaluate effectiveness of O2 rx.
  137. Counterindications for Pulse Oximetry
    when COHb or MetHb is present, when displayed HR is different from actual HR, when SpO2 reading is < 70%, neonates <1500g
  138. PtO2 sensor temperatures
    42-44 degrees C
  139. Alveolar-Arterial Oxygen Pressure Difference
    should be no greater than 15 torr
  140. PaO2/FiO2 Ratio (P/F Ratio)
    • Normal = 400-500 torr
    • Weaning can be attempted = 150 torr
    • ALI = 200-300 torr
    • ARDS = <200
  141. Oxygenation Index
    • OI = ((FiO2xPaw)/PaO2) x 100
    • Gap widens with lung dysfunction. Supplemental O2 little benefit, use PEEP.
Card Set
Comp Review
comp review