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4th semester (test 2)
Alveolar Gas Exchange
Characteristics
Pulmonary Artery Blood is O2-Poor, CO2-Rich
Two-Cell Thick Air-Blood Barrier
CO2 Diffuses Into Air
O2 Diffuses Into Blood
Gases Equilibrate
Pulmonary Vein is O2-Rich, CO2-Poor
Thermoregulation
2 mins
Blood Acid-Base Control
Characteristics
In a State of Acidemia
Medullary Chemoreceptors Control Ventilation Rate
Expulsion of CO2 through Lungs Increases pH
Bicarbonate Reabsorption from the Kidney Increases pH
Kidney Excretion of H+ Increases pH
2 mins
Pulmonary Embolism Assessment
Assessment
Shortness of Breath (SOB)
Pleuritic Chest Pain
Tachypnea
Hemoptysis
Hypoxemia
Considerations
Sudden Death
52 secs
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
1 min
Local Anesthetic Overview
Indications
Minor Procedures
Epidurals
Mechanism of Action
Blocks Na+ Channels
State Dependent
Combined with Vasoconstrictors
Infected Tissue Requires Higher Dose
Drugs
Esters
Amides
Side Effects
Arrhythmias
Cardiotoxicity
1 min
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
2 mins
Respiratory Acidosis Interventions
Improve Respiration
Pharmacologic Interventions
Bronchodilators
Respiratory Stimulants
Drug Antagonists
Nonpharmacologic Interventions
Oxygen
Assisted Ventilation
Prevent Complications
1 min
Respiratory Alkalosis Assessment
Assessment
Increased pH > 7.45
Decreased PaCO2 < 35 mmHg
Hyperventilation
Brainstem Stimulation
Head Injury
Shock
Lightheadedness
Tingling Lips or Fingers
Trousseau's
Chvostek's Sign
Anxiety
2 mins
Respiratory Acidosis Assessment
Assessment
Decreased pH < 7.35
Increased PaCO2 > 45
Reduced Respirations
Anxiety
Change in LOC
Tachycardia
Cyanosis
Increased Electrolytes
ECG Changes
Muscle Weakness
Hyporeflexia
2 mins
Anticholinergics Continued
Drugs
Glycopyrrolate
Reduces Airway Secretions
Ulcer Treatment
Ipratropium
Asthma and C.O.P.D
Dicyclomine
Hyoscyamine
Irritable Bowel Syndrome
1 min
Metabolic Acidosis Interventions
Interventions
Raise Plasma pH > 7.20
Treat Underlying Cause
Sodium Bicarbonate
Considerations
Follow ABGs
Continuously Monitor Patient
2 mins
Metabolic Alkalosis Interventions
Interventions
Treat Underlying Cause
Stop Potassium (K+) Wasting Diuretics
Spironolactone
Acetazolamide
IV Fluids
Sodium Chloride
Replace Potassium (K+)
Considerations
Monitor Respiratory Rate
Monitor Heart Rate
Seizure Precautions
2 mins
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
1 min
Metabolic Acidosis Assessment
Characteristics
Decreased pH < 7.35
Decreased HCO3 < 22
Signs & Symptoms
Abdominal Pain
CNS Depression
Coma
Hypotension
Arrhythmias
Increased Respirations
Kussmaul Respirations
Flushed, Warm, Dry Skin
Muscle Weakness
2 mins
How to Interpret Acid Base Disorders
pH, pCO₂, HCO₃ (Bicarbonate)
Step 1
pH
Acidosis
Alkalosis
Step 2
pCOâ‚‚
Opposite Direction as pH
Respiratory Acidosis
Respiratory Alkalosis
Step 3
HCO₃ (Bicarbonate)
Same Direction as pH
Metabolic Acidosis
Metabolic Alkalosis
3 mins
Respiratory Acidosis
Hypoventilation
Increased PaCO2 > 45
Barbiturates Depress Central Respiratory Center of Brain
Opioids Depress Central Respiratory Center of the Brain
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