NSG 533 Pulmonary Exam |! |! |! |!
with accurate detailed |! |! |!
solutions
Blood Gas values - Correct answer ✔pH: 7.35-7.45
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PaO2: 80-100 |!
PaCO2: 35-45 |!
Ventilation - Correct answer ✔The movement of air in and out of lungs - a
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function of tidal volume and respiratory rate. Analyze PaCO2.
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-Inversely related to PaCO2 -- if a person is breathing slowly and
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shallowly, PaCO2 will be high. |! |! |! |!
Oxygenation - Correct answer ✔The process of delivering oxygen to the
|! |! |! |! |! |! |! |! |! |! |!
blood by diffusion from the alveoli following inhalation into the lungs.
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- Three measures to analyze: SaO2 (95-100%), PaO2 (80-100), and
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hemoglobin (~ 15) |! |!
PaO2 is oxygen available to tissues.
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Work of breathing - Resistance - Correct answer ✔How much pressure we
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need to generate to get the flow in.
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- If we clear secretions, maybe don't need a ventilator.
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, Work of breathing - Compliance - Correct answer ✔How much volume do
|! |! |! |! |! |! |! |! |! |! |! |!
we need to bring in to inflate the alveoli.
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-If we decrease fluid and fix pulmonary edema, maybe we don't need a
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ventilator.
-Compliance is the opposite of elasticity. A thick rubber band is very elastic |! |! |! |! |! |! |! |! |! |! |! |!
but has low compliance (requires more pressure to inflate).
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-A skinny rubber band is not elastic but has high compliance (easy to
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inflate).
Low compliance - Correct answer ✔Stiff lung (high elastic recoil): thick
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balloon, often seen in fibrosis. |! |! |! |!
High compliance - Correct answer ✔Pliable lung (low elastic recoil):
|! |! |! |! |! |! |! |! |! |!
grocery bag, often seen in emphysema. |! |! |! |! |!
A-a gradient - Correct answer ✔Measures the difference between the
|! |! |! |! |! |! |! |! |! |!
oxygen concentration in the alveoli and arterial system.
|! |! |! |! |! |! |!
-Normal is 12-15 |! |!
A=alveolar oxygen |!
a=arterial oxygen |!
Causes of hypoxemia - Correct answer ✔Right-to-left shunt,
|! |! |! |! |! |! |! |!
hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch |! |! |! |! |! |! |! |!
Normal A-a O2 gradient - Correct answer ✔*Low PIO2 (low inhaled O2
|! |! |! |! |! |! |! |! |! |! |! |!
concentration)
-high elevation or house fires |! |! |! |!
with accurate detailed |! |! |!
solutions
Blood Gas values - Correct answer ✔pH: 7.35-7.45
|! |! |! |! |! |! |!
PaO2: 80-100 |!
PaCO2: 35-45 |!
Ventilation - Correct answer ✔The movement of air in and out of lungs - a
|! |! |! |! |! |! |! |! |! |! |! |! |! |! |!
function of tidal volume and respiratory rate. Analyze PaCO2.
|! |! |! |! |! |! |! |!
-Inversely related to PaCO2 -- if a person is breathing slowly and
|! |! |! |! |! |! |! |! |! |! |! |!
shallowly, PaCO2 will be high. |! |! |! |!
Oxygenation - Correct answer ✔The process of delivering oxygen to the
|! |! |! |! |! |! |! |! |! |! |!
blood by diffusion from the alveoli following inhalation into the lungs.
|! |! |! |! |! |! |! |! |! |!
- Three measures to analyze: SaO2 (95-100%), PaO2 (80-100), and
|! |! |! |! |! |! |! |! |! |!
hemoglobin (~ 15) |! |!
PaO2 is oxygen available to tissues.
|! |! |! |! |!
Work of breathing - Resistance - Correct answer ✔How much pressure we
|! |! |! |! |! |! |! |! |! |! |!
need to generate to get the flow in.
|! |! |! |! |! |! |! |! |!
- If we clear secretions, maybe don't need a ventilator.
|! |! |! |! |! |! |! |! |!
, Work of breathing - Compliance - Correct answer ✔How much volume do
|! |! |! |! |! |! |! |! |! |! |! |!
we need to bring in to inflate the alveoli.
|! |! |! |! |! |! |! |!
-If we decrease fluid and fix pulmonary edema, maybe we don't need a
|! |! |! |! |! |! |! |! |! |! |! |! |!
ventilator.
-Compliance is the opposite of elasticity. A thick rubber band is very elastic |! |! |! |! |! |! |! |! |! |! |! |!
but has low compliance (requires more pressure to inflate).
|! |! |! |! |! |! |! |! |! |!
-A skinny rubber band is not elastic but has high compliance (easy to
|! |! |! |! |! |! |! |! |! |! |! |! |!
inflate).
Low compliance - Correct answer ✔Stiff lung (high elastic recoil): thick
|! |! |! |! |! |! |! |! |! |! |!
balloon, often seen in fibrosis. |! |! |! |!
High compliance - Correct answer ✔Pliable lung (low elastic recoil):
|! |! |! |! |! |! |! |! |! |!
grocery bag, often seen in emphysema. |! |! |! |! |!
A-a gradient - Correct answer ✔Measures the difference between the
|! |! |! |! |! |! |! |! |! |!
oxygen concentration in the alveoli and arterial system.
|! |! |! |! |! |! |!
-Normal is 12-15 |! |!
A=alveolar oxygen |!
a=arterial oxygen |!
Causes of hypoxemia - Correct answer ✔Right-to-left shunt,
|! |! |! |! |! |! |! |!
hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch |! |! |! |! |! |! |! |!
Normal A-a O2 gradient - Correct answer ✔*Low PIO2 (low inhaled O2
|! |! |! |! |! |! |! |! |! |! |! |!
concentration)
-high elevation or house fires |! |! |! |!
