Rle Ncm106 Abg Interpretation

7/28/2019 Rle Ncm106 Abg Interpretation

1/12

SET 1.

A. Mr. Frank is a 60 year-old with pneumonia. He is admitted with dyspnea, fever, andchills. His blood gas is below:pH 7.28

CO2 56PO2 70HCO3 25SaO2 89%

What is your interpretation?

What interventions would be appropriate for Mr. Frank?

B. Ms. Strauss is a 24 year-old college student. She has a history of Crohn's diseaseand is complaining a of a four day history of bloody-watery diarrhea. A blood gas is

obtained to assess her acid/base balance:pH 7.28CO2 43pO2 88HCO3 20SaO2 96%


What interventions would be appropriate for Ms. Strauss?

C. Mrs. Lauder has a fully-compensated respiratory acidosis with hypoxemia. Fullcompensation is evidenced by the normal pH in spite of her acid/base disorder. This is

her baseline and doesn't require treatment.

pH 7.37CO2 63pO2 58HCO3 35SaO2 89%


What interventions would be appropriate for Mrs. Lauder?


2/12

SET 1 ANSWERS

A. Mr. Frank has an uncompensated respiratory acidosis with hypoxemia as a result ofhis pneumonia. This is due to inadequate ventilation and perfusion. The treatment goalsfor Mr. Frank would be to improve both ventilation and oxygenation. Ventilation may

improve with the use of bronchodilators and pulmonary hygiene. If not, Mr. Frank mayrequire CPAP, BiPAP, or intubation and mechanical ventilation. Oxygen therapy shouldconsist of only the minimal amount necessary to increase his oxygen saturation tonormal (95%).

B. Ms. Strauss has an uncompensated metabolic acidosis. This is due to excessivebicarbonate loss from her diarrhea. It is interesting to note that she has nocompensation. Normally, the respiratory center compensates quickly for metabolicdisorders. However, in Ms. Strauss' case she would have to hyperventilate in order tocompensate. This may not be possible in her present condition, and should beevaluated further. Treatment would consist of control of the diarrhea and bowel rest. It

should not be necessary to administer bicarbonate in her present condition.

C. Mrs. Lauder has a fully-compensated respiratory acidosis with hypoxemia. Fullcompensation is evidenced by the normal pH in spite of her acid/base disorder. This isher baseline and doesn't require treatment.


3/12

SET 2

A. Ms. Aquino is a 17 year-old with intractable vomiting. She has some electrolyteabnormalities, so a blood gas is obtained to assess her acid/base balance.pH 7.50

CO2 36pO2 92HCO3 27SaO2 97%


What interventions would be appropriate for Ms. Steele?

B. Mr. Alba is a 18 year-old comatose, quadriplegic patient who has the following ABGdone as part of a medical workup:

pH 7.48CO2 22pO2 96HCO3 16SaO2 98%


What interventions would be appropriate for Mr. Longo?

C. Mrs. Lapel has a fully-compensated respiratory acidosis with hypoxemia. Full

compensation is evidenced by the normal pH in spite of her acid/base disorder. This isher baseline and doesn't require treatment.

pH 7.37CO2 63pO2 58HCO3 35SaO2 89%


What interventions would be appropriate for Mrs. Lauder?


4/12


5/12

SET 3

A. Ms. Jose is a 24 year-old college student. She has a history of Crohn's disease andis complaining a of a four day history of bloody-watery diarrhea. A blood gas is obtainedto assess her acid/base balance:

pH 7.28CO2 43pO2 88HCO3 20SaO2 96%


What interventions would be appropriate for Ms. Strauss?

B. Ms. Garys is a 17 year-old with intractable vomiting. She has some electrolyte

abnormalities, so a blood gas is obtained to assess her acid/base balance.pH 7.50CO2 36pO2 92HCO3 27SaO2 97%


What interventions would be appropriate for Ms. Steele?

C. Mr. Davies is a 60 year-old with pneumonia. He is admitted with dyspnea, fever, andchills. His blood gas is below:pH 7.28CO2 56PO2 70HCO3 25SaO2 89%


What interventions would be appropriate for Mr. Frank?


6/12

SET 3 ANSWERS

A. Ms. Jose has an uncompensated metabolic acidosis. This is due to excessivebicarbonate loss from her diarrhea. It is interesting to note that she has nocompensation. Normally, the respiratory center compensates quickly for metabolic

disorders. However, in Ms. Strauss' case she would have to hyperventilate in order tocompensate. This may not be possible in her present condition, and should beevaluated further. Treatment would consist of control of the diarrhea and bowel rest. Itshould not be necessary to administer bicarbonate in her present condition.

B. Ms. Garys has an uncompensated metabolic alkalosis. This is due to vomiting thatresults in excessive loss of stomach acid. Treatment consists of fluids, anti-emetics, andmanagement of her electrolyte disorders

C. Mr. Davies has an uncompensated respiratory acidosis with hypoxemia as a result ofhis pneumonia. This is due to inadequate ventilation and perfusion. The treatment goals

for Mr. Frank would be to improve both ventilation and oxygenation. Ventilation mayimprove with the use of bronchodilators and pulmonary hygiene. If not, Mr. Frank mayrequire CPAP, BiPAP, or intubation and mechanical ventilation. Oxygen therapy shouldconsist of only the minimal amount necessary to increase his oxygen saturation tonormal (95%).


7/12

SET 1

A.

What is the Heart rate?What is the PR Interval?What is the QRS interval?What is the Rhythm ?What is your interpretationB.

What is the Heart rate?What is the PR Interval?What is the QRS interval?What is the Rhythm ?What is your interpretation



8/12

SET 2

A.

What is the Heart rate?What is the PR Interval?What is the QRS interval?

What is the Rhythm ?What is your interpretation

B.


C.



9/12

SET 3

A.

What is the Heart rate?What is the PR Interval?

What is the QRS interval?What is the Rhythm ?What is your interpretation

B.


C.

What is the Heart rate?What is the PR Interval?What is the QRS interval?


10/12

What is the Rhythm ?What is your interpretation

1. Delivers pre-set volumes at a pre-set rate and a pre-set flow rate. The patientCANNOT generate spontaneous volumes, or flow rates in this mode. Eachpatient generated respiratory effort over and above the set rate are delivered at

the set volume and flow rate.Answer: Assist/Control Mode

2. Delivers a pre-set number of breaths at a et volume and flow rate. Allows thepatient to generate spontaneous breaths, volumes, and flow rates betweenthe set breaths. Detects a patients spontaneous breath attempt and doesntinitiate a ventilatory breath prevents breath stacking

Answer: SYCHRONIZED INTERMITTENT MANDATORY VENTILATION

3. This is a volume targeted, pressure limited mode Each breath is delivered at aset volume with a variable flow rate and an absolute pressure limit. The vent

delivers this pre-set volume at the LOWEST required peak pressure and adjustwith each breathANSWER: PRESSURE REGULATED VOLUME CONTROL

4. This IS a mode and simply means that a pre-set pressure is present in thecircuit and lungs throughout both the inspiratory and expiratory phases of thebreath

Answer: Continuous Positive Airway Pressure


11/12

SET 1IDENTIFICATION:

A. This is a volume targeted, pressure limited mode Each breath is delivered at aset volume with a variable flow rate and an absolute pressure limit. The ventdelivers this pre-set volume at the LOWEST required peak pressure and adjustwith each breath

B. Delivers a pre-set number of breaths at a set volume and flow rate. Allows thepatient to generate spontaneous breaths, volumes, and flow rates betweenthe set breaths. Detects a patients spontaneous breath attempt and doesntinitiate a ventilatory breath prevents breath stacking

C. Delivers pre-set volumes at a pre-set rate and a pre-set flow rate. The patientCANNOT generate spontaneous volumes, or flow rates in this mode. Eachpatient generated respiratory effort over and above the set rate are delivered atthe set volume and flow rate.

SET 2

A. This IS a mode and simply means that a pre-set pressure is present in thecircuit and lungs throughout both the inspiratory and expiratory phases of thebreath

B. This is a volume targeted, pressure limited mode Each breath is delivered at aset volume with a variable flow rate and an absolute pressure limit. The ventdelivers this pre-set volume at the LOWEST required peak pressure and adjustwith each breath

C. Delivers a pre-set number of breaths at a et volume and flow rate. Allows thepatient to generate spontaneous breaths, volumes, and flow rates betweenthe set breaths. Detects a patients spontaneous breath attempt and doesntinitiate a ventilatory breath prevents breath stacking


12/12

SET 3

A. Delivers a pre-set number of breaths at a et volume and flow rate. Allows thepatient to generate spontaneous breaths, volumes, and flow rates betweenthe set breaths. Detects a patients spontaneous breath attempt and doesntinitiate a ventilatory breath prevents breath stacking

B. This is a volume targeted, pressure limited mode Each breath is delivered at aset volume with a variable flow rate and an absolute pressure limit. The ventdelivers this pre-set volume at the LOWEST required peak pressure and adjustwith each breath

C. This IS a mode and simply means that a pre-set pressure is present in the circuitand lungs throughout both the inspiratory and expiratory phases of the breath

Documents

Rle Ncm106 Abg Interpretation