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Final Jeopardy
Oxygen
Physiology
Calculations
Patient
Cases
Decision
Time
Potpourri
Cardiac
Anatomy
10 Point
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Respiratory
Quotient
What is the ratio
of carbon dioxide
production to
oxygen
consumption?
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
What is the intrathoracic
pump?
Poor humidity and
high FiO2 impair
function of these
structures which can
lead to lower airway
infection and mucous
plugging.
What is the
mucous layer and
cilia?
Your patient has increased
expiratory work and collapse of
small airways during forced
exhalation
What are problems
due to increased
lung compliance?
Alveoli that have
both poor
ventilation and
poor circulation.
What are silent
units?
This formula is
written as
(Hgb X 1.34 X SaO2) + (PaO2 x 0.003)
What is Oxygen
Content of Arterial
Blood?
The formula for
oxygen
consumption.
What is
V02 = (CO)[(C(a-v)O2) x 10]
Diagnostic criteria
for ARDS is < 200
What is the P/F
Ratio?
The amount (%) of
oxygen normally
extracted by the
body.
What is 25%
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.
What is the shunt
equation?
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 __________.
Question 1c
Your H1N1 patient has a
PaO2 of 129 on a FiO2 of
50%. What is your
assessment of
oxygenation?
What is Acute Lung
Injury?
Your patient comes into the
emergency room with hypoxia.
List two methods used to
differentiate between
hypoventilation and shunting.
What are ABG and a/A gradient
calculation?
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 vascularity
b.ABG – 7.33 / 62 / 34, PaO2 – 52 torr and SaO2 – 83%
c.CBC – WBC =18,000, H&H = 18/56
d.Electrolytes – all within normal limits
1. What is the DO2?
2. 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)
Your patient is
bleeding and has a
low CO. As a
result, DO2 is
______.
What is decreased?
Your patient is
anemic. The O2ER
is ________.
What is increased?
You have been bagging
on 100% O2 and the
PaO2 is now 300 torr
with a SpO2 of 100%.
The SvO2 is ____.
What is increased?
Your patient has an
increased VO2 and an
increased O2ER. A
clinical example of this
condition would be…
What is fever or
infection?
Your patient has
polycythemia due
to chronic hypoxia.
The D(a-v)O2 is
_____.
What is
unchanged?
The a/A ratio.
What is a useful
tool in titrating
FiO2 with high
paO2s?
A device used to open a
blocked artery.
What is a stent?
A critical factor in
coronary blood
flow.
What is diastolic
time?
4 causes of
increased oxygen
consumption.
What are
Metabolic Rate
Neurohormonal factors
Stress /Pain/Anxiety
Some medications
Activity (baths/turning)
Fever
Infection
Three indications
for oxygen therapy.
What are decrease
work of breathing,
decrease work of the
heart, and increase
PaO2?
The ____ valves are
open during
diastole.
What are mitral and
tricuspid valves?
These valves are
open during
systole.
What are
pulmonic and
aortic?
Pericardial Effusion
What is fluid in the
pericardial sac?
The difference
between a
pericardial
effusion and
tamponade.
What is significant
cardiac
compression
causing
impairment?
Stenosis
What is narrowing
of vessels?
Make your wager
The relation of
pulmonary shunt
to myocardial
blood supply.
What is used myocardial
blood dumping into the
coronary sinus causing a
3%-5% shunt?