Gas Exchange Basics
What is a normal PaO2?
80-100mmHg
Name 2 hallmark manifestations of COPD.
chronic cough, dyspnea
What position improves oxygenation in patients with COPD?
High Fowler's
What 2 vital signs are often changed first in sepsis?
Blood pressure and heart rate
What is a normal range for SpO2?
95-100%
What is the difference between hypoxemia and hypoxia?
Hypoxemia is low oxygen in the blood while hypoxia is low oxygen in tissues
What two diseases make up COPD?
Emphysema and bronchitis
Name 2 breathing exercises used for COPD patients
incentive spirometry & pursed lip breathing
What is a broad spectrum antibiotic that can be used for sepsis?
Zosyn
What is a normal range for PaCO2?
35-45 mmHg
Name an example of when there would be ventilation without perfusion.
Pulmonary embolism
Why should high flow oxygen be used cautiously in patients with COPD?
High O2 delivery can suppress hypoxic drive and decreases respiratory effort
A COPD patients O2 is at 90%. What is the nurse's priority action?
No immediate action is needed. COPD patient's oxygen saturation goal is between 88-92%
Administer IV fluids
Which respiratory pattern is characterized by deep, rapid breathing?
Kussmaul respirations
What is the difference between ventilation and perfusion?
Ventilation is the movement of air in and out of the lungs while perfusion is the flow of blood through the circulatory system that delivers oxygen to the tissues
What is the pathophysiological difference between emphysema and bronchitis?
Chronic bronchitis involves airway inflammation, mucus production, and a cough
Emphysema involves alveolar wall destruction
Your patient with COPD becomes anxious and restless. What is your priority action?
Assess oxygenation, apply oxygen if necessary, provide calm environment
What are 2 labs that are used to diagnose sepsis?
WBC count, lactic acid, procalcitonin, CRP
What device can deliver up to 60L of oxygen?
High flow nasal cannula
What are 5 modifiable risk factors to prevent alterations in gas exchange?
Smoking, sedentary lifestyle, drug/alcohol use, obesity, poor diet, exposure to air pollutants
Why are corticosteroids prescribed for COPD management? Name two.
Prednisone, methylprednisolone, fluticasone, budesonide
What noninvasive test is used to check circulation before obtaining an ABG?
Allan test
A septic patient's BP is still 80/50 after fluids have been running. What type of medication would you expect to be administered?
Vasopressors (ex. norepinephrine)
Interpret this ABG: pH 7.37, PaCO2 55mmHg, HCO3 32, PaO2 68 mmHg
fully compensated respiratory acidosis