Blood Gases and Respiratory Acidosis

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Questions and Answers

What primarily causes septic shock?

Excessive blood pressure during infection

Rapid increase in blood volume

Hypotension from sepsis that cannot be reversed with fluid resuscitation (correct)

Increased production of red blood cells

Which of the following is a result of dysregulated immune response in sepsis?

Inadequate blood flow to vital organs (correct)

Decreased permeability of blood vessels

Formation of new blood vessels

Increased tissue oxygenation

What is a consequence of the excessive release of pro-inflammatory cytokines during sepsis?

Tissue and organ damage (correct)

Inhibition of immune cell activity

Reduction in vasodilation

Improved coagulation processes

What factor contributes to the loss of fluid from the bloodstream in septic shock?

Increased permeability of blood vessels Signup and view all the answers

Which group of patients is at higher risk for sepsis due to impaired immune response from chemotherapy?

Patients receiving chemotherapy Signup and view all the answers

What is the primary effect of loss of sympathetic tone in neurogenic shock?

Widespread vasodilation Signup and view all the answers

What can cause the failure of the sympathetic nervous system?

Emotional distress or pain Signup and view all the answers

Which hormone is primarily used in vasopressor therapy for neurogenic shock?

Norepinephrine Signup and view all the answers

During neurogenic shock, what condition may occur as a result of increased parasympathetic activity?

Bradycardia Signup and view all the answers

What is a symptom of compensated shock?

Increased heart rate Signup and view all the answers

What treatment is crucial for managing oxygenation in neurogenic shock?

Intubation and ventilation Signup and view all the answers

What is a key characteristic of decompensated shock?

Low blood volume and perfusion Signup and view all the answers

What is the primary goal of fluid administration in neurogenic shock?

To avoid overloading the system with fluid Signup and view all the answers

What characterizes absolute hypovolemic shock?

Fluid loss through bleeding or diarrhea Signup and view all the answers

What is the primary physiological consequence of hypovolemic shock?

Decreased venous return and cardiac output Signup and view all the answers

At what percentage of blood volume loss does mild hypovolemic shock occur?

Under 20% Signup and view all the answers

Which sign is typically observed early in hypovolemic shock?

Altered level of consciousness Signup and view all the answers

What treatment is critical in managing hypovolemic shock?

Aggressive fluid resuscitation Signup and view all the answers

In a patient with severe hypovolemic shock, what percentage of fluid loss is indicated?

Over 40% Signup and view all the answers

What is a compensatory mechanism when the body experiences hypovolemic shock?

Increased respiratory rate and depth Signup and view all the answers

What is not a typical late sign of hypovolemic shock?

Normal level of consciousness Signup and view all the answers

What is the primary role of the hypodermis in the body?

Acting as a shock absorber and energy source Signup and view all the answers

Which type of burn is most commonly caused by heat?

Thermal burns Signup and view all the answers

What does liquefactive necrosis in alkaline burns indicate?

Tissue turns to liquid and continues to cause damage Signup and view all the answers

Which factor is critical in determining the extent of electrical injury?

Duration of contact and type of current Signup and view all the answers

What might electrical injuries cause during the first 24 hours?

Lethal cardiac dysrhythmias Signup and view all the answers

Why should poison control be consulted in cases of chemical burns?

To understand the pH of the chemical agent Signup and view all the answers

What should be monitored to prevent acute kidney injury (AKI) in electrical burns?

Urine output Signup and view all the answers

What mechanism contributes to the 'iceberg effect' in electrical burns?

External wounds are minimal compared to internal damage Signup and view all the answers

What is the primary concern during the emergent phase of burn care?

Airway management Signup and view all the answers

What fluid and electrolyte imbalance commonly develops in the first 24 hours after a burn injury?

Hyponatremia Signup and view all the answers

Which method is preferred for assessing burn size in pediatric patients?

Lund Browder chart Signup and view all the answers

What complication is most associated with burns covering 20% or more of total body surface area in adults?

Systemic complications Signup and view all the answers

How does oxidative stress affect cardiac function after a burn injury?

Depresses cardiac function Signup and view all the answers

What best describes the fluid movement during the first 24 hours post-burn injury?

Third spacing into interstitial space Signup and view all the answers

What is a significant risk of hypovolemic shock after a burn injury?

Decreased skin turgor Signup and view all the answers

Which method helps calculate the burn area for patchy or noncontinuous burns?

Palmar method Signup and view all the answers

What is a common gastrointestinal complication associated with burn shock?

Paralytic ileus Signup and view all the answers

What is the urine output goal for monitoring acute kidney injury in burn patients?

30-50 ml/hr Signup and view all the answers

What is the mechanism by which hypovolemia can lead to acute kidney injury in burn patients?

Decreased blood flow to the kidneys Signup and view all the answers

Which of the following is part of the Parkland formula for fluid resuscitation?

4 ml Ringer's lactate per kg per percentage of TBSA burned Signup and view all the answers

What proportion of fluid should be administered in the first 8 hours according to the Parkland formula?

50% Signup and view all the answers

What complication may arise due to the compromised skin integrity in burn patients?

Hypothermia Signup and view all the answers

What should be done if myoglobin is present in the urine of burn patients?

Maintain a higher urine output Signup and view all the answers

Which factor is primarily responsible for fluid shifts following burns?

Increased capillary permeability Signup and view all the answers

Study Notes

Blood Gases

Prioritize patient presentation over numbers. Treat patient, not just the numbers.
Normal partial pressure of oxygen (pO2) is 80-100 mmHg.
Saturation of hemoglobin with oxygen (SpO2) is a measure of how much oxygen is bound to hemoglobin.
Low pH indicates acidity, High pH indicates alkalinity.
Carbonic acid (H2CO3) is a key component in acid-base balance.
Lungs rapidly regulate CO2, while kidneys slowly regulate bicarbonate.
Buffers regulate hydrogen ions; if blood is acidic, hydrogen moves into cells, and potassium moves out, leading to hyperkalemia. Conversely, if basic, potassium entering cells results in hypokalemia.
Compensation involves adjustments in CO2 or bicarbonate to restore pH balance if one component is disrupted.

Respiratory Acidosis

Causes: hypoventilation, airway obstructions, CNS depression, sleep apnea, neuromuscular issues, increased metabolism.
Symptoms: Hypoventilation, rapid shallow respirations, hyperkalemia, dysrhythmias (irregular heartbeats).

Respiratory Alkalosis

Causes: hyperventilation, CNS stimulation, hypoxia, stimulation of chest receptors (e.g., pain, anxiety), drugs.
Symptoms: Seizures, lethargy, confusion, deep rapid breathing, tachycardia, hypokalemia, numbness/tingling.

Metabolic Acidosis

Causes: HCO3 loss (diarrhea, DKA, methanol intoxication, uremia, lactic acidosis), increased H+ production or ingestion.
Symptoms: headache, decreased BP, hyperkalemia, muscle twitching, warm/flushed skin, nausea/vomiting/diarrhea, Kussmaul respirations (deep, rapid breathing).

Metabolic Alkalosis

Causes: GI loss of H+ (vomiting), renal loss of H+, burns, excessive bicarbonate.
Symptoms: confusion, nausea/vomiting/diarrhea, tremors, muscle cramps, tingling, hypokalemia, altered LOC.

Liver Functions

Detoxification: removes harmful substances (drugs, alcohol, toxins).
Metabolism: converts hormones, and other substances.
Protein synthesis: makes blood clotting factors, cholesterol, and other proteins.
Bile production: aids digestion of fats.
Storage of nutrients: vitamins, minerals, sugars.
Immune function: helps fight infection and maintain immune system health.
Blood sugar regulation: stores and releases glucose.

Liver Disease

Diagnostic tests: CBC, liver function tests (AST, ALT, GGT), bilirubin, PT/INR, albumin.
Liver biopsy may be needed in some cases.
Acute liver failure: rapid deterioration of liver function.
Hepatitis: inflammation of the liver.
Cirrhosis: chronic progressive liver disease with fibrosis (scar tissue).

Complications of Cirrhosis

Portal hypertension: high blood pressure in the portal vein.
Esophageal varices: swollen blood vessels in the esophagus prone to bleeding.
Ascites: fluid buildup in the abdominal cavity.
Hepatic encephalopathy: brain dysfunction due to liver failure (impaired ammonia metabolism).

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Description

This quiz covers key concepts related to blood gases and respiratory acidosis, emphasizing the importance of treating the patient over just numbers. You'll learn about pO2, SpO2, acid-base balance, and the causes and symptoms of respiratory acidosis.