Comp Review

hyperthermia, fever, acidosis, hypoxemia, anxiety, pain

hypothermia, alkalosis, hyperoxia

contractility of LV, arterial resistance, blood volume

60-100/20-70

cardiac rhythm disturbances, muscle weakness

flat or inverted T waves, depression of ST segments, PVCs, V Fib

prolongation of ST segment & QT interval

high, peaked T waves, depressed ST segments, wide QRS complexes, bradycardia

shortened QT interval, widened and rounded T waves

95-106 mEq/L

3.5-5.5 mEq/L

135-145 mEq/L

4.5-5.5 mEq/L

23-25 mEq/L

70-110 mg/100 mL

cardiac enzyme, increases 4-6 hours after MI

cardiac enzyme, increases 2-4 hours after MI

cardiac enzyme, increases 2-4 hours after MI

cardiac enzyme, elevated in pt with CHF

non specific enzyme, marker of inflammation linked to risk for MI, stroke & PV disease

13.5-18.0 g/100 mL

40%-54%

4.6-6.2 million/mL

elevated WBC, signals bacterial infection

acute, severe bacterial infection

4500-11000 mm3

low (3000-5000/mm3, suggests acute viral infection

11-12.5 seconds

60-70 seconds

30-40 seconds

Gram-positive

tachycardia, hypotension, high urine specific gravity, oliguria, low CVP, low PCWP, poor skin turgor, slow capillary refill, mental confusion

tachycardia, hypertension, low urine specific gravity, increased urine output, increased CVP, increased PWCP, peripheral edema, pulmonary edema (crackles/rales)

<10 mm Hg

significant change in CP condition, following invasive thoracic procedure, hemoptysis, suspected pulmonary infarct, suspected 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

suspected FB aspiration, laryngeal edema, laryngeal tumor, laryngotrachealbronchitis, epiglottitis

tumor, hematoma, abscess/cyst, aortic or vascular abnormality, trauma, FB

imaging of head, spinal cord, heart, great vessels, kidneys, liver, other organs

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

suspected pulmonary embolism or airway obstruction

proper positioning, exposure

standard view, accurate heart size, deep breath

heart size appears larger than actual

visualize behind heart & hemidiaphragms, localize lesions, measure AP diameter

check heart borders, mediastinal structures, hilar structures & lung masses

allows visualization of fluid in pleural spaces or pulmonary cysts

id small pneumothorax in an infant

visualization of upper lung fields

dense, absorb more radiation, appear white

have little density, absorb less radiation, appear darker

atelectasis or pulmonary fibrosis

tension pneumothorax

atelectasis, pulmonary fibrosis, hepatomegaly

>50%

pleural effusion

pleural effusion

fluffy white infiltrates in one or both lung fields, more common in LL, great vessels may also be englarged

dense white shadows, air bornchograms may be visible

shock or hypoxemia

normal respiratory pattern

conditions that increase density result in more intense vibrations

vibrations from airway secretions

pneumonia, atelectasis, consolidation

pneumothorax, pleural effusion, bronchial obstruction

pulmonary edema, ARDS

thick chest wall, COPD

0-15, 15 being normally awake/alert and 0 being nonresponsive

shallow breathing

slow breathing

rapid breathing

croup, epiglottitis, FB, laryngeal edema, airway trauma

asthma, COPD, CF, airway tumor, trauma

rapid deep breaths, usually secondary to acidosis (eso. diabetes)

waxing and waning breaths with periods of apnea: head injury, stroke, high ICP, CHF

variable depth and frequency of respirations with periods of apnea: meningitis,brain injury, brain tumor, increased ICP

mid-inspiratory cough

Negative pressure room, gloves, handwashing NIOSH-approved mask (N95), eye protection: TB, varicella, rubeola, H1N1, SARS

in addition to Standard Precautions: private or cohort room, isolation mask; haemophilus influenza type b, meningitis, myco[lasma pneumoniae, bordetella pertussis

In addition to standard precuations: private.cohort room, gloves, gown, dedicated equipment:C. difficile, MRSA, respiratory syncytial virus, herpes zoster

provides protection against 23 most prevalent or invasive types strep pneumoniae bacteria.

seasonal, protection against three strains of virus

chlorine compound (bleach)

1.25% solution of acetic acid (vinegar) - soak 60 minutes

determine the presence & quantity of dyshemoglobins such as carboxyhemoglobin and methemoglobin

calculate a patient's oxygen carrying capacity

estimate the acid-base balance and adequacy of ventilation: should not be used to estimate oxygenation

evaluate pH in patients with uremia or diabetic ketoacidosis

measured oxygen would be inaccurately higher and measured carbon dioxide level would be inaccurately lower: pH would be inaccurately high

reduce the pH and pCO2 and increase the O2 level

15

42 degrees C

Sanz

Severinghaus

Clark

the oxygen that is dissolved in the plasma and not from the oxygen bound to the hemoglobin

that the measured physiologic values truly reflect the actual physiologic values

that a high degree of confidence exists that the measured values represent the patient's actual physiologic values

the results are not only accurate and reliable but also are clinically useful

pCO2 = (Pb - P H2O) x % CO2, where Pb = barometric pressure and pH2O is water vapor pressure

pO2 = (Pb - PH2O) x % O2

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

oxyhemoglobin, carboxyhemoglobin, methemoglobin and reduced hemoglobin

they may absorb the same wavelengths and report inaccurately lower oxygemoglobin than is actually present

the presence of lipids causes total hemoglobin readings that are falsely high and falsely low measurements of oxyhemoglobin and carboxyhemoglobin.

40-70 torr

>80 torr

• paO2 60-79 torr
• SaO2 90-94%

• paO2 40-59 torr
• SaO2 75-89%

• paO2 < 40 torr
• SaO2 <75%

HCO3 > 24 mEq/L or BE > 1

HCO3 < 24 mEq/L or BE <-1

respiratory acidosis, alveolar hypoventilation, ventilatory failure

acidemia

respiratory alkalosis, alveolar hyperventilation

alkalosis

acute ventilatory failure

chronic ventilatory failure

Metabolic alkalosis

metabolic acidosis

partially compensated metabolic alkalosis

chronic ventilatory failure

acute ventilatory failure

acute alveolar hyperventilation

chronic alveolar hyperventilation

compensated metabolic acidosis

partially compensated metabolic acidosis

15.0 g/dL

94-100%

<1.5%

0.5 - 3%

15-23 g/dL

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

Mixed venous pO2 < 30 or mixed venous sat of <56

>92%

during procedures, postop, when patient is sedated, during sleep studies, during periods of respiratory distress, to evaluate effectiveness of O2 rx.

when COHb or MetHb is present, when displayed HR is different from actual HR, when SpO2 reading is < 70%, neonates <1500g

42-44 degrees C

should be no greater than 15 torr

• Normal = 400-500 torr
• Weaning can be attempted = 150 torr
• ALI = 200-300 torr
• ARDS = <200

• OI = ((FiO2xPaw)/PaO2) x 100
• Gap widens with lung dysfunction. Supplemental O2 little benefit, use PEEP.