(Diagnostics) Malley - Chapter 4 - Blood Gas Electrodes (COPIED) STUDY THIS

One must be especially cautious in interpreting ________ in a patient with leukemia.

PaO2

The effects of excessive liquid sodium heparin on a blood gas sample are:

1. related to the partial pressures of the gases in the liquid.

2. related to the pH of the liquid heparin.

3. related to the buffer systems in the heparin.

1. related to the partial pressures of the gases in the liquid.

2. related to the pH of the liquid heparin.

Which of the following suggest a blood gas sample may be venous?

1. Observation of a flash of blood as the syringe begins filling

2. Bluish coloration of the blood sample

3. Failure of syringe to auto-fill

4. Brownish coloration of blood

2. Bluish coloration of the blood sample

3. Failure of syringe to auto-fill

Temperature correction of blood gases:

1. clearly provides the optimal way to guide clinical decision-making.

2. is only indicated when patient temperature exceeds 40° C.

3. is easily accomplished with most blood gas machines.

3. is easily accomplished with most blood gas machines.

Placing a blood sample in an ice-water solution will interfere with analysis of blood:

Electrolytes

An instrument that measures an unknown voltage by comparing it with a known reference voltage is?

Potentiometer

Dr Bescey and his ARNP M. Armstrong are arguing over what electrode the "SANZ" is. They ask you and you confidently tell them...

pH

A substance through which electrons can flow is called?

Conductor

Of the 3 Electrodes, which is the least accurate?

Clark

The Half-Cell where the actual electrochemical change takes place is called the

Working Half-cell

(T/F) Janine has just moved to the Tampa area and has been an RT for 30 years. She is not ready to retire yet but also does not want to be on her feet for 12 hours a day. She finds and is offered a job in Tampa General's blood gas lab. She started to re-educate herself on Blood Gas Errors and she thinks she remembers someone telling her the following "A blood gas lab has to determine the mean and standard deviation for each of its instruments"?

True

The Lab has to perform Linearity and Correlation studies on a_____

6 month basis

(T/F) Co-oximitry is less accurate the pulse oximitry

False

In reference to Cooximetry, Up to how many wave lengths are used to determine the fractional components ofhemoglobin?

23

What amino acid breakdown produces NO (Nitric Oxide).

L-Arginine

Which of the following is NOT a NO Synthase (NOS) enzyme?

Glycine

What year was NO (Nitric Oxide) first detected in exhaled breath

1991

(T/F) iNOS are thought to be the main contributor to elevated exhaled NO in asthmatics?

True

(T/F) An adult with a eNO level of 76 ppb would be considered in a normal range and has no inflammation process happening.

False

Asbestosis

Shipyard worker

Beryllium Disease

Aerospace worker

Silicosis

Sand blasters

Hypersensitivity pneumonitis

mushroom farmer

Fred is a cabinet and countertop fabricator, and has been for 20 years. He is at a higher risk of contracting this disease.

Silicosis

From the list of gases, which one is colorless and used during WWI as a chemical weapon

Phosgene

Brendon worked for NASA until 2001 in the shuttle fleet prep assembly building. Soon after retiring Brendon started having breathing issues, after extensive testing he was diagnosed with this disease ___________________________, which was a direct result of being exposed at his workplace.

Beryllium Disease

(T/F) The safety committee at Hawks Hospital is comprised of Sarah, Kyle, Diane and Jeff After much research and debate the decide that limiting exposure and Ventilation systems are both examples of prevention goals concerning occupational exposures.

True

If you take inspiratory Capacity and subtract Tidal volume you get this

IRV

Subtract ERV from FRC and you are left with this?

Residual Volume RV

Subtract IRV and ERV from VC and you are left with?

Tidal Volume

What volume can not be measured with spirometers

Residual Volume RV

ERV in obstructive diseases will be?

Decreased or Normal

Adding ERV and RV will give you this?

FRC

If you take TLC and you subtract RV you are left with?

VC

This capacity usually makes up 60% to 70% of the Vital Capacity (VC)

Inspiratory Capacity IC

What makes up TLC

All 4 volumes (IRV, ERV, RV and Tidal Volume)

With a restrictive disease your FVC and FEV1 will be?

Reduced

Normal FEV1/FVC ratio

70% or greater

What are the two primary measurements that are measured in a body box?

FRC and Raw

This type of expiratory maneuver is used when measuring a FVC?

Forced Exhalation

Measuring a patients maximal inspiration produces this capacity?

Inspiratory Capacity IC

The amount of air exhaled forcefully in one second is known as this?

FEV1

What is the name of the Scale used in the 6 minute walk test?

Borg

Bronchoprovocators like histamine and methacholine are used in this test?

Bronchial challenge

This test ends when N2 < 1% for 3 breaths

Nitrogen Washout

This test has the patient breathe as fast and deep as possible for 12-15 seconds?

Maximum Voluntary Ventilation MVV

Decreased DLCO (< 80% of predicted) would indicate which of the following diseases?

COPD

FVC 81%, FEV1 76%, FEV1/FVC 79%

Is this Normal, Obstructive, Restrictive or Mixed?

Normal

FVC 50%, FEV1 44%, FEV1/FVC 75%

Is this Normal, Obstructive, Restrictive or Mixed?

Restrictive

What is the minimum percent increase in forced spirometric volumes after a bronchodilator is given that would indicate reversible airway obstruction?

Greater then 10-12%

FVC 80%, FEV1 50%, FEV1/FVC 50%

Is this Normal, Obstructive, Restrictive or Mixed?

Obstructive

Which of the following flow-volume graphs shows emphysema?

Normal for MVV?

170 L/min

Volume inspired with normal breath?

Tidal Volume

Bronchial challenge testing typically used to determine this disease?

Asthma

Body Plethysmograph (BODY BOX)

is based on what law?

Boyle's Law

Substance used in bronchial provocation test?

methacholine (sometimes histamines)

A person who is born and lives at sea level will develop a slightly smaller lung capacity than a person who spends their life at a high altitude. Why? What causes this?

Because the partial pressure of oxygen is lower at higher altitude which, as a result means that oxygen less readily diffuses into the bloodstream

"Control moving in one direction– heading toward an “out of control” value" is a definition of what?

Trend

what is the statistical measure of the amount of which a set of values differ from the arithmetic mean:

Standard Deviation

What is shown here?

Shift

The three regulation agencies for blood gas labs are ACHA, PAC, JCAHO

False

Electricity is defined as what?

§  Type of energy resulting from flow of electrons through a substance

Conductor is defined as what?

Substance the electrons flow through

Energy source is defined as what?

Battery or generator that provides power, 2 connections from electrons to flow

Cathode is defined as what?

 Negative pole on energy source of excess of stored electrons

Anode is defined as what?

Positive pole on energy source, lack of electrons

What is work?

Electrons move away from the cathode through the conductor moving through to the anode.

What direction does electricity flow?

Negative to positive

What is volts?

Voltage refers to electromotive potential

What is current?

The flow of electrons through the conductor

What is Ampere? or AMP

The unit of measure of the current

What is resistance?

The materials tendency to resist the flow of a charge

What is Omh?

Measurement unit of the resistance of a material.

Formula for Ohms law?

Volt = Current x resistance

What is watts?

Consumption of electric power

Watts formula?

Volts x AMP

What electrode is the Clark electrode?

Po2

What electrode is the SANZ electrode?

pH

What electrode is the Severinghaus one?

Pco2

What is going on in the image?

Trend