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Physiology Oxygen Calculations Patient Cases Decision Time Potpourri Cardiac Anatomy 10 Point 10 Point 10 Point 10 Point 10 Point 10 Point 20 Points 20 Points 20 Points 20 Points 20 Points 20 Points 30 Points 30 Points 30 Points 30 Points 30 Points 30 Points 40 Points 40 Points 40 Points 40 Points 40 Points 40 Points 50 Points 50 Points 50 Points 50 Points 50 Points 50 Points
The phenomenon of negative pressure inside the chest causing blood to be sucked up toward the right atrium via the vena cava from the lower extremities
Poor humidity and high FiO2 impair function of these structures which can lead to lower airway infection and mucous plugging.
Your patient has increased expiratory work and collapse of small airways during forced exhalation
Alveoli that have both poor ventilation and poor circulation.
This formula is written as (Hgb X 1.34 X SaO2) + (PaO2 x 0.003)
What is V02 = (CO)[(C(a-v)O2) x 10]
This is the portion of the cardiac output that does NOT take part in gas exchange. Once the severity is established, treatment plans can be made.
Your AM ABG shows a PaO2 of 165 torr on 55% O2. You receive an order from Dr. Smith to reduce the FiO2 for a target PaO2 of 80 torr. Your new FiO2 should be __________.
Your H1N1 patient has a PaO2 of 129 on a FiO2 of 50%. What is your assessment of oxygenation?
Your patient comes into the emergency room with hypoxia. List two methods used to differentiate between hypoventilation and shunting.
You receive a patient in the ER with the following ABG: pH 7.5, paCO2 32, paO2 76, SaO2 65%, COHb 25%. The pulse ox is reading 92%. Interpret the ABG and recommend treatment.
What is acute alveolar hyperventilation with severe hypoxemia secondary to carbon monoxide poisoning? Treat with 100% oxygen.
A patient arrives in the ER sent directly from his physician's office. He is a 62 Y/O male with a 25 pack year smoking history. His ideal body weight is 182 lbs. He had severe dyspnea and a weak cough effort. Auscultation reveals course expiratory crackles and inspiratory crackles at the bases, aeration is faint. The patient has JVD and it is noted that he has dependent edema 2+. His respiratory rate is 22 and shallow.Vital signs are: 167/66, HR 125, Temp. 38.2 C, pulse oximeter = 86% on 2 liters per minute nasal cannula. CO is 8 lpm.a.CXR – bilateral cloudy infiltrates with prominent vascularityb.ABG – 7.33 / 62 / 34, PaO2 – 52 torr and SaO2 – 83%c.CBC – WBC =18,000, H&H = 18/56d.Electrolytes – all within normal limits • What is the DO2? • What factors are contributing to the patient’s hypoxia?
1. 2. hypoventilation, alveolar fluid, infiltrates, abnormal alveoli, possible COHb, altered cardiac function, increased oxygen consumption (fever, incr wob, tachycardia, stress, infection)
You have been bagging on 100% O2 and the PaO2 is now 300 torr with a SpO2 of 100%. The SvO2 is ____.
Your patient has an increased VO2 and an increased O2ER. A clinical example of this condition would be…
Your patient has polycythemia due to chronic hypoxia. The D(a-v)O2 is _____.