Question Answer
When the pH is increased [hydrogen ion concentration (H+) is decreased], in which direction will the HbO2 Dissociation Curve shift? A. To the “left”
In what direction does the Oxygen (HbO2) Dissociation Curve shift when the pH is decreased? D. To the right
The Ventilation/Perfusion ratio (V/Q) represents which one of the following? A. Changes in alveolar ventilation (VA) and pulmonary capillary blood flow (QC)
In which direction will the O2 Dissociation Curve shift, due to an increase in body temperature? A. To the right
100% O2 may not be sufficient to achieve satisfactory arterial oxygen content under which of the following conditions? C. Hypoxemia due to physiological shunting
The impact of changes in blood pH on hemoglobin’s affinity for oxygen is called the B. Bohr effect
) Which of the following describes hypoxia? A. Blood Hb levels are greater than normal (>16 g/dL). B. Tissue O2 delivery is inadequate to meet cellular needs.
List the 3 different ways CO2 is transported in the blood to the lungs along with the percentage for each form. HCO3- 80% Carbamino-Hb 12% Dissolved in Plasma 8%
(9) What is the overall main goal of acid- base homeostasis? Maintain a normal blood pH
True or False: A buffer solution allows large changes in pH upon the addition of an acid or base. False
True or False The HCO3- represents the respiratory component of an acidbase system. False
With respect to the excretion of H+ and reabsorption, how will the kidneys respond if the blood PaCO2 is high? Excrete H+ and retain HCO3-
True or False According to the Henderson-Hasselbalch equation, the pH of the blood will be normal as long as the ratio of HCO3 to dissolved CO2 is 30 to 1 (30:1). False
True or False: In respiratory alkalosis the PaCO2 is less than 35 mmHg True
True or False The most common cause of HYPERVENTIALTION in patients with respiratory disease is probably due to a low arterial PaO2 (hypoxemia). True
True or False Compensation for respiratory acidosis occurs through a decrease in blood HCO3 levels. False
True or False Compensation for metabolic acidosis occurs through a decrease in blood PCO2 levels True
True or False In acute respiratory acidosis, for each 10 mm Hg rise in PCO2 above 40 mmHg the plasma HCO3- can be expected to increase by about 1 mEq/L. True
An increase in body temperature will shift the oxygen dissociation curve in what direction? B. Right
True or False: The impact of changes in blood pH on hemoglobin affinity for oxygen is called the chloride shift False
The ______________ alters the position of the HbO2 Dissociation curve. D. Bohr Effect
In healthy young adults, what is considered a normal of PAO2-PaO2 gradient (A-a Gradient)? D. 5 to 10 mm Hg
Which of the following contains the highest level of PCO2? C. Cells
All of the following increase the affinity that hemoglobin has for oxygen except: Increased temperature
The normal total oxygen content of the blood is approximately C. 19.5 mL/dL
What is the normal CaO2-CvO2 (arteriovenous oxygen content difference) in a healthy adult at rest? D. 5 mL/dL
Which of the following approximate a normal P50? B. 26.6 mmHg
A PaO2 of 100 mmHg is normally associated with a hemoglobin saturation (SaO2) of _______________. A. 97%
What would be the approximate hemoglobin saturation (SaO2) associated with a PaO2 of 65 mmHg? A. 90%
Where is the lowest PO2 normally found? B. Cells
The majority of oxygen (O2) is carried: B. Chemically combined with Hb
The majority of carbon dioxide is carried: D. As bicarbonate ion (HCO3)
Based on the following values, calculate the Oxygen Delivery (DO2): CaO2 = 16 ml/dl & Cardiac Output 6.0 L/min DO2 = 6 (16 x 10) DO2 = 6(160) DO2 = 960 ml
There is a total of 14 g/dL hemoglobin (Hb) in the blood, of which 7.5 g is HbO2. What is the calculated SaO2 (%)? SaO2 = 7.5 / 14 x 100 SaO2 = 54%
While receiving an oxygen concentration (FIO2) of 65%, a patient’s PaO2 is 50 mmHg. What is the mostly likely causing this problem? A. Significant shunting is present
“Hyperventilation” is normally seen as the compensatory mechanism for _________________. C. Metabolic Acidosis
Why is the bicarbonate buffer system, considered an open buffer system? B. Its acid component (carbonic acid) is volatile.
What is the ratio of HCO3 – to dissolved CO2 that results in a pH of 7.40? 20:1
Which statement below describes “respiratory alkalosis”? C. The PaCO2 is less than 35 mmHg
Primary metabolic alkalosis is associated with which of the following? III. An increase in buffer base
Which of the following might be used to correct metabolic alkalosis? I. Restoring normal fluid volume C. I, and III only
An increase in the hydrogen ion concentration [H+] of the blood due only to an increase in the arterial PCO2 (hypercapnea), best describes which acid-base disorder? Acute respiratory acidosis
Interpret the following set of ABG values: pH = 7.22, PCO2 = 60 mm Hg, HCO3 = 24 mEq/L C. Acute (uncompensated) respiratory acidosis
Which of the following describe the state of “alkalemia”? I. The HCO3:CO2 ratio exceeds 30:1. II. The blood pH exceeds 7.45. D. I and II only
What is the normal range of PAO2-PaO2 gradient (A-a Gradient) for a healthy young adult breathing room air? 5 to 10 mmHg
Which equation describes O2 delivery to the tissues? DO2 = QT x [CaO2 x 10]
Describe the PaO2. What is it? Oxygen dissolved in the blood plasma
Under what conditions may even the delivery of 100% O2 not be sufficient to achieve a satisfactory arterial oxygen content? When physiologic “shunting” is present
A patient with a normal PaO2, SaO2 and cardiac output is exhibiting signs and symptoms of tissue hypoxia. What is the most likely cause? Anemic hypoxia
How is the vast majority of O2 carried in the blood? Combined with Hb
True or False: Gas solubility in liquids varies indirectly with pressure. False
True or False: Changes in atmospheric pressure have little to do with gas transport in the body. False
If 100 ml of a 50% solution (A) were exposed to 100 ml of a 30% solution (B) across a semipermeable membrane, what would be the strength of each solution following equilibrium? 40%
True or False: Average body cellular fluid has a tonicity equal to a 0.9% solution of NaCl. This is referred to as an isotonic solution. True
Cite the formula used to calculate the gram-equivalnet weight of a substance. gEq = Gram atomic (formula) weight ÷ Valence
True or False: 10 grams of solute dissolved 100 ml of solution can be described as weight to volume solution. True
True or False: An acid can be defined as a proton donor or a compound that yields hydrogen ions when placed in an aqueous solution and a base can be defined as any compound that will accept a proton.. True
What maintains the volume and composition of body fluids? I. Filtration and reabsorption of sodium by the kidneys. II. Regulation of water balance by vasopressin (ADH).A. I and II
True or False: Evaporative water loss through the lungs may occur due to the presence of an artificial airway and through increased ventilation True
The alveolar interstitial region of the lungs remains relatively “dry” primarily because of what? A. Low capillary hydrostatic pressure
True or False: The normal range for potassium (K+) is 10 to 15 mEq/L False


Question Answer
Venticlation is cyclic: Inspiration & Expiration Tidal Volume:normal breathingFacilitates removal of co2 replenishes o2
Transrespiratory-atmosphere to alveoliTranspulmonary-alveoli to pleuraTransthoracic-pleura to body surface Gradient-High to low. Bigger the gradient the easier to breath.HGB-70% 1.34 mL 30% dissolve plasma
Compliance is the lungs ability to stretch. Surfactant keep alveoli opened and stablilized. Type II pneumocytes produce surfactant. Production around 28 wks of birth.
.2 is normal compliance. The higher the pressure, the lower the compliance. Normal Tidal Volume is 300mL
RAW is airway resistance. Nose has the most airway resistance. Normal range is 0.5-2.5 cm H2O/L/sec Support comes from cartilage, and “traction” from surrounding tissues.
WOB is how much effort it takes to breath. Emphysema-compliance goes down, elasticity goes up.COPD-Compliance goes up, elasticity goes down.
More than 5% use of breathing means respiratory distress. 4 Life Functions: Ventilation, Oxygenation, Circulation, Perfusion
V/Q Match-Better blood flow at bottom of lungs b/c of gravity. Hyperventilation- PaCO2 <35mm HgHypoventilation- PaCO2 > 45mm Hg
The apex of the heart lies just above the diaphragm at a level corresponding to the fifth intercostal space. The loose membranous sac that encloses the heart is called the pericardium.
Tissues that make up the heart wall include the endo, epi, and myocardium. Most of the hearts muscle mass is located in the left ventricle.
The mitral valve prevents atrial backflow during ventricular contraction. Narrowing of the mitral valve can result in increased pulmonary congestion.
The smeilunar valves seperate the ventricles from their arterial outflow tracts. The coronary arteries are the first arteries to branch off the ascending aorta.
The major branches of the left coronary artery are the anterior descending and the circumflex. Normal Flow of blood in heart: RA, Tricuspid valve, RV, pulm. valve, pulmonary artery, pulmonary veins, LA, mitral valve, LV, aortic valve
Arterioles in the body act like faucets, controlling the flow of blood into the cappillary beds. Sympathetic venometer tone, cardiac suction, and skeletal muscle contraction all facilitate venous return to the heart.
Pulmonary vascular bed is referred to as a low pressure, low resistance system. Normal resting cardiac output is 5000 mL/min
When all 3 are high or low- you interpret dx system by PH & Bicarb. Steps to Dtermine ABG’s:1) Acidic or Alkalitic2)Resp or Metab.(Dx System & PH)3)If CO2 & HCO3 abnormal (Compensated)4)If compensated (PH Normal-Fully) (PH Abnormal-Partially)
ABG’s are drawn from Arterial Blood. Normal ABG Levels:PH 7.35-7.45, PaCO2 35-45, HCO3(Bicarb) 22-24, PaO2- 80-100, SaO
Respiratory: PaCO2 increases PH decreases or vice versa- Inverse RelationshipMetabolic_HCO3 increases PH increases or vice versa-Direct relationship. Acidic Neutral Base 1 7 14
Respiratory System controls CO2Example: Not breathing-, CO2 high Fast Breathing-< CO2 Low Renal System controls bicarbonateExample= PH = 7.30 low PaCO2= 45 Normal Metabolic HCO3= 19 Low Acidosis
Anything(PaCO2) less than 80 you have a big decrease in saturation. PH, Body Temp, and 2,3 DPG makes curve shift left or right. 2,3 DPG stablizes red blood cells.
PH increases curve shifts Lft.PH decreases curve shifts Rt.Blinker System:Body Temp increases curve shifts rtBody Temp decreases curve shifts lft2,3 DPG increases curve shifts rt2,3 DPG decreases curve shifts lft. If CO2 is high PH Low. PH is low if it shifts right which makes o2 sats low.
Apex is where the heart beats the strongest. Left Anterior Descending( LAD)= Widow Maker
Blockage of blood flow thru the coronary arteries is called a myocardial infarction. Veins, arteries and nerves usually travel together.
Heart beat is rhythmic and regular. 60-100 beats per minute. SA Node signals heart on how fast, h9ow hard and how often to beat.
Lub Dubb- noise valves make when they are closing. Ateries carry blood away from the heart. Veins carry blood to the heart. Capillariescarry blood from arterioles to venules.
Factors that influence blood pressure:Blood VolumeStrength of contractionsBlood ViscosityResistance to blood flow Normal BP 120/80
 
Question Answer
1. Describe at least two types of patients that Respiratory Care Practitioners encounter on a daily basis. COPD, Asthma, Geriatric, trauma, stroke, neonatal/pediatric
Identify three areas in which you will find Respiratory Care Practitioners. Emergency rooms, intensive care units, cardiac care untits, neonatal/pediatric intensive care units,
What is the minimum amount of years required in order to become a Respiratory Therapist? two years
What does RCP stand for? respiratory care practioner
At what liter flow do you set a simple oxygen mask? 5-10L/min
What is the reason why a nasal cannula may not deliver a specific FiO2? patient can breathe through mouth
What is the range of FiO2 that can be delivered by Venturi Masks? 28-50% FiO2
CPAP continuos positive airway pressure
OSA obstuctive sleep apnea
What is the potential FiO2 that a Non-Rebreather Mask can deliver? 100% FiO2
At what liter flow do you set a nasal cannula? 1-6 Liters/min
What is the primary purpose of Oropharyngeal Airway? a tube inserted through the mouth and pharynx so that the tongue does not block air flow in an unconscious person
IPAP inspiratory positive airway pressure
EPAP expiratory positive airway pressure
What is the primary purpose of a Nasopharyngeal Airway? air conditioning and delivery
Through which organization are the credentialing exams taken? NBRC – National Board of Respiratory Care
A RCP’s license will be issued by which organization? Respiratory Care Board of California
What is the minimum amount of CEU’s that’s required of RCP’s, and how often do we have to renew? 15 units every 2 years
How often are RCP’s required to take an Ethics course? every 4 years
What is the definition of an exacerbation? increase in severity of a disease or any of its symptoms.
Know the significance of the HYPOXIC DRIVE Most people feel need to inhale and exhale depending on varying levels of CO2 in their bloodstream. Sufferers from COPD, however, have chronically elevated CO2 levels, waiting for a hypoxic dip in their oxygen level as the signal to increase respiration.
how is oxygen carried in the blood? hemoglobin and plasma
What causes shifts in Oxy-Hb Dissociation Curve? Body temperature, 2,3,DPG, PCO2, pH
Question Answer
1. Describe at least two types of patients that Respiratory Care Practitioners encounter on a daily basis. COPD, Asthma, Geriatric, trauma, stroke, neonatal/pediatric
Identify three areas in which you will find Respiratory Care Practitioners. Emergency rooms, intensive care units, cardiac care untits, neonatal/pediatric intensive care units,
What is the minimum amount of years required in order to become a Respiratory Therapist? two years
What does RCP stand for? respiratory care practioner
At what liter flow do you set a simple oxygen mask? 5-10L/min
What is the reason why a nasal cannula may not deliver a specific FiO2? patient can breathe through mouth
What is the range of FiO2 that can be delivered by Venturi Masks? 28-50% FiO2
CPAP continuos positive airway pressure
OSA obstuctive sleep apnea
What is the potential FiO2 that a Non-Rebreather Mask can deliver? 100% FiO2
At what liter flow do you set a nasal cannula? 1-6 Liters/min
What is the primary purpose of Oropharyngeal Airway? a tube inserted through the mouth and pharynx so that the tongue does not block air flow in an unconscious person
IPAP inspiratory positive airway pressure
EPAP expiratory positive airway pressure
What is the primary purpose of a Nasopharyngeal Airway? air conditioning and delivery
Through which organization are the credentialing exams taken? NBRC – National Board of Respiratory Care
A RCP’s license will be issued by which organization? Respiratory Care Board of California
What is the minimum amount of CEU’s that’s required of RCP’s, and how often do we have to renew? 15 units every 2 years
How often are RCP’s required to take an Ethics course? every 4 years
What is the definition of an exacerbation? increase in severity of a disease or any of its symptoms.
Know the significance of the HYPOXIC DRIVE Most people feel need to inhale and exhale depending on varying levels of CO2 in their bloodstream. Sufferers from COPD, however, have chronically elevated CO2 levels, waiting for a hypoxic dip in their oxygen level as the signal to increase respiration.
how is oxygen carried in the blood? hemoglobin and plasma
What causes shifts in Oxy-Hb Dissociation Curve? Body temperature, 2,3,DPG, PCO2, pH