Term
What 2 places can you put a pulse oximeter?
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Definition
| 1) Index finger 2) Ear lobe |
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Term
| What is another name for Pulse Ox? |
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Definition
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Term
| What does PAO2, SaO2, and PaO2? |
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Definition
1) PAO2- Partial pressure of O2 in Alveoli (around 100mmHg)
2) PaO2- partial pressure of oxygen in arterial blood (100mmHg)
3) SaO2- percent saturation of hemoglobin in arterial blood ( greater than or equal to 90%) |
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Term
| Fill in the blank: PAO2 is ___ times greater than the FiO2. |
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Definition
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Term
| Fill in the blank: AA gradient can be _____ by a shunt |
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Definition
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Term
| How are HgB and Hct related? |
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Definition
| Hb is found inside the Hct (since Hct is RBC) |
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Term
| Define Hct (2 definitions) |
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Definition
1) percentage of RBC in blood
2) Percentage of blood that is NOT plasma |
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Term
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Definition
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Term
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Definition
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Term
| What is the main function of Hb? |
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Definition
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Term
| How many subunits (and types of subunits) of Hb exist in one RBC? |
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Definition
| 4 subunits (2 alpha, 2 beta) on one RBC |
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Term
| Where is heme found and what does it contain? |
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Definition
| Heme found in each subunit of Hb, and it contains Porphyrin ring and Fe+ |
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Term
| Where is iron specifically found in the RBC and what does it do? |
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Definition
| Iron is found in heme component of the Hb (which is part of RBC) and it binds to O2 |
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Term
| How many heme and iron components exist in one RBC? |
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Definition
| 4 Fe+ and 4 Heme component |
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Term
| What is the decrease in Hb? (Define) |
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Definition
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Term
| Can anemia only be caused genetically or can happen in other situations? |
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Definition
| Can happend genetically and in other situations not factored by genetics |
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Term
| List atleast 4 causes of Anemia? |
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Definition
1) Dec. in EPO (which causes a dec. in RBC --> Decrease in Hb)
2) Blood loss (loosing blood--> Hb is a component of blood, so Hb is lost too --> Dec. in Hb
3) Fluid adminstration (inc. fluids --> dilute blood --> Dec. Hct levels --> dec. Hb levels
4) Lysed RBC (Caused by lysed RBC--> hct level dec. -->Hb part of RBC --> Dec. in Hb
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Term
| Case scenario: A female is giving birth (Para 3) and once here baby was born, was diagnosed for a chronic case of Jaundice and enlarged liver, if we were to put a Pulse Ox on this child what would it read and why? and what additional lab tests would you order to work on your diagnosis? |
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Definition
You should order blood work done, espically for the prescence of antigens of Rh factor. Most likely this pt. is suffering from Erythroblastosis fetalis and the babies jaundic indicates low levels of Hb, thus dec. Hb levels. Thus causing a low reading from Pulse Ox.
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Term
| Fill in the blanks: each Hb can bind ____ O2 molecules |
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Definition
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Term
| Fill in the blanks: If you have an increase in Hct levels (due to dehydration/blood loss), what will happen to Hb levels? |
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Definition
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Term
| Fill in the blanks: Hct is roughly ____ times the Hb |
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Definition
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Term
| What is the Hb level (g/dL) if Hct levels is 30%? |
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Definition
| Since Hct is 3X the level of Hb, 30%/3 = 10 g/dL |
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Term
Which one is not a way of determining PAO2?
1) FiO2
2) Minute Ventilation
3) Low Barometric pressure
4) RR |
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Definition
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Term
| What are the 2 primary determinants of PAO2? |
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Definition
1) FiO2
2) Barometric Pressure (elevation) |
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Term
| What is PAO2 minimally determined by? Why? |
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Definition
| Minute Ventilation; even if you increase the MV you will still have the same FiO2 |
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Term
| How can you measure PAO2? |
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Definition
| You can't measure PAO2, must be calculated by looking at FiO2. FiO2 is 1/5 the PAO2 |
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Term
| What is the level of PAO2 in normal air? |
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Definition
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Term
| What units is PAO2 measured in? |
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Definition
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Term
| How is FiO2 and PAO2 related? |
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Definition
| PAO2 is 5 times the FiO2 in healthy pt's |
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Term
| What is the PP of O2 dissolved in blood? |
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Definition
| PaO2 (partila Pressure of arterial O2) |
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Term
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Definition
| By PAO2 (which causes a change in the A-a gradient) |
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Term
| What can cause a high PAO2 and low PAO2? and how will they effect the PaO2 |
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Definition
1) High PAO2: High FiO2, increased Barometric pressure (below sea level)- Causes high PaO2 (due to high A-a gradient)
2) Low PAO2: Low FiO2 and decreased Barometric Pressure (above sea level-ex. Colorado)- causes Low PaO2 (due to low A-a gradient) |
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Term
| How does a larger A-a gradient cause increased PaO2? |
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Definition
| A-a gradient determined by the concentration of O2 in alveoli vs the arterial blood, the larger the gradient the more O2 diffuses into the blood, thus causing an inc. in PaO2 |
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Term
Choose which one does not affect PaO2?
1) Large A-a gradient
2) Increase in PAO2
3) Minute ventilation
4) Amount of Hb in blood
5) Amount of O2 bound to Hb |
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Definition
| 4 and 5; 1,2,3 change the PAO2, which changed the PaO2 |
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Term
| How do you measure the PaO2? |
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Definition
| Draw blood sample (unlike PAO2, where you have to calculate it) |
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Term
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Definition
| Difference between PAO2 and PaO2 |
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Term
| What is the A-a gradient in room temperature and 100% O2? |
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Definition
1) Room temp: 5-15mmHg
2)100% FiO2: 10-110mmHg |
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Term
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Definition
| SaO2- Percentage of Hemoglobin saturated with O2 |
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Term
| What is SaO2 determined by? |
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Definition
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Term
| How is SaO2 determined by PaO2? |
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Definition
| More O2 dissolved in blood (higher PaO2)= Greater chance for maximal saturation, and Hb soaks up O2 from blood until maximally saturated |
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Term
| If you have an increased FiO2 (caused at low sea level) what change would occur in PAO2, PaO2, SaO2? |
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Definition
Inc. FiO2= Inc. PAO2 (>100mmHg)= Inc. PaO2 = Inc. SaO2 (100%)
** This is why we give pt's 100% O2, becuase it makes their SaO2 at 100% (more tissue oxygenation) |
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Term
| T/F: SaO2 has an effect on PaO2? |
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Definition
| False, only PaO2 can have effect on SaO2. If the pressure of O2 dissolved in blood increases then the Hb soaks upthe O2 from blood until maximally saturated. |
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Term
| What are the secondary determinants of SaO2? or (what alters the way Hb soaks up the O2) |
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Definition
| 1) PH 2) CO2 3) Temperature 4)Anemia 5) 2,3 DPG 6)Carboxyhemoglobin levels 7)Methemoglobin levels |
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Term
| What are the Y and X axis of the Hb dissociation curve? |
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Definition
| X-axis is the PaO2 (Pressure of O2 DISSOLVED in blood) and Y-axis is the SaO2 (PERCENTAGE of Hb saturated with O2) |
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Term
| Dec. PH, Inc. CO2 and Inc. 2,3 DPG would shift the Hb dissociation curve to the ____. |
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Definition
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Term
| Name 4 reasons Hb dissociation curve would shift to the right? and indicate what that means in relevance to O2 binding? |
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Definition
Reasons: 1) inc. DPG 2) Acidosis (inc. H+ and CO2) 3) Anemia 4) Hyperthermia (inc. Temp)
Indication: Means the O2 isnt holding onto Hb as well, thus more o2 delivery to tissues=Better O2 delivery to tissues.
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Term
| Which shift in the Hb dissociation curve causes a higher PaO2 to achieve the same SaO2? |
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Definition
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Term
| Describe what happens to PaO2 and SaO2 when you shift the graph to the left? (when comparing to normal Hb dissociation graph) |
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Definition
| The PaO2 decreases to reach the normal SaO2 level |
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Term
| How does the affinity of O2 change when you shif the curve (Hb dissociation curve) to the left? |
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Definition
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Term
| Which causes worse o2 delivery to tissues, shifting the curve to the Right or left ?(On the Hb dissociation curve) |
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Definition
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Term
| what are 5 things that causes Hb dissociation curve to shift to the left? |
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Definition
| 1) Alkalosis (Dec. CO2, Inc. PH) 2) Dec. 2,3 DPG 3) Hypothermia (Low. temp) 4)metHb 5) COHb |
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Term
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Definition
| The PaO2 when the SaO2 is 50% (or when the Hb is saturated with 50% bound O2) |
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Term
| Looking at the Hb dissociation curve what is the P50 for 1) Adult 2) Fetal 3) Pregnant 4)Sickle Cell 5) PRBC's |
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Definition
Adult: 27mmHg
Fetal:19mmHg
Pregnant: 30mmHg
Sickle Celll: 31mmHg
PRBC: 17mmhg |
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Term
| Name the direct and Indirect ways of measuring SaO2? |
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Definition
Direct: Draw blood sample
Indirect: Pulse Ox. |
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Term
| What does Pulse Ox measure? |
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Definition
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