Pulmonary CCRN- Critical Care Registered Nurse Study
Questions 2024/2025 Fully Answered 100%
What is ventilation? - ANSWERThe mechanical movement of air in and out of the
lungs
How is ventilation in the body controlled? - ANSWERCentral control = pH of blood
(lower pH, ventilation is stimulated. Increased rate and depth)
Peripheral control = PaO2 sensors in aortic arch (decrease in PaO2 ventilation is
stimulated)
What is the clinical indicator of ventilation? - ANSWERPaCO2
What is minute ventilation? - ANSWERAmount of air moved in a minute
Vt (tidal volume) X respiratory rate
What is the normal value for minute ventilation? - ANSWER~4L minute
What is dead space ventilation and how is it calculated? - ANSWERAmount of air that
does not participate in gas exchange
Anatomic dead space = 2mL/kg of Vt
Alveolar dead space = pathologic, non-perfused, PE
Physiologic dead space = Anatomic dead space + alveolar dead space
A pulmonary embolism results in: - ANSWERAn increase in pulmonary dead space
Normal Ventilation/perfusion ratio - ANSWERVentilation 4L
________________
Perfusion 5L
= 0.8
The good lung should be in which position? - ANSWERGood lung down
Right pneumonia - left lung down (more blood goes down due to gravity)
How is V/Q mismatch treated? - ANSWERGive supplemental O2
Correct underlying problem
How is a pulmonary shunt treated? - ANSWERO2 (100%)
, PEEP: increases alveolar recruitment, prevents alveolar collapse
What is a shunt? - ANSWERMovement of blood from the right side of the heart to
the left side without picking up oxygen
Normal range for PaO2 - ANSWER80-100 mmHg on room air
Normal range for SvO2 - ANSWER60-75%
What is the most sensitive indicator of oxygenation at the cellular level? -
ANSWERMixed venous oxygen saturation (SvO2) - directly measured at the
pulmonary artery
Conditions that cause a left shift on the Oxyhemoglobin Dissociation Curve -
ANSWERAlkalosis
Low PaCO2
Hypothermia
Low 2,3-DPG
Conditions that cause a right shift on the Oxyhemoglobin Dissociation Curve -
ANSWERAcidosis
High PaCO2
Fever
High 2,3-DPG
What happens when the oxyhemoglobin dissociation curve shifts to the left? -
ANSWEROxygen does not release from hemoglobin as easily. SaO2 is higher, but the
tissues do not receive the oxygen they need.
What is 2,3-Diphosphoglycerate (2,3-DPG)? - ANSWERAn organic phosphate found in
RBCs that has the ability to alter the affinity of Hgb for oxygen
What does a decrease in 2,3-DPG lead to? - ANSWERHemoglobin holding on to O2
What does an increase in 2,3-DPG lead to? - ANSWERHemoglobin more readily
releasing O2
Factors that may lead to a decreased 2,3-DPG - ANSWERMultiple blood transfusions
Hypophosphatemia
Hypothyroidism
Factors that may lead to an increased 2,3-DPG - ANSWERChronic hypoxemia (high
altitudes, chronic HF)
Questions 2024/2025 Fully Answered 100%
What is ventilation? - ANSWERThe mechanical movement of air in and out of the
lungs
How is ventilation in the body controlled? - ANSWERCentral control = pH of blood
(lower pH, ventilation is stimulated. Increased rate and depth)
Peripheral control = PaO2 sensors in aortic arch (decrease in PaO2 ventilation is
stimulated)
What is the clinical indicator of ventilation? - ANSWERPaCO2
What is minute ventilation? - ANSWERAmount of air moved in a minute
Vt (tidal volume) X respiratory rate
What is the normal value for minute ventilation? - ANSWER~4L minute
What is dead space ventilation and how is it calculated? - ANSWERAmount of air that
does not participate in gas exchange
Anatomic dead space = 2mL/kg of Vt
Alveolar dead space = pathologic, non-perfused, PE
Physiologic dead space = Anatomic dead space + alveolar dead space
A pulmonary embolism results in: - ANSWERAn increase in pulmonary dead space
Normal Ventilation/perfusion ratio - ANSWERVentilation 4L
________________
Perfusion 5L
= 0.8
The good lung should be in which position? - ANSWERGood lung down
Right pneumonia - left lung down (more blood goes down due to gravity)
How is V/Q mismatch treated? - ANSWERGive supplemental O2
Correct underlying problem
How is a pulmonary shunt treated? - ANSWERO2 (100%)
, PEEP: increases alveolar recruitment, prevents alveolar collapse
What is a shunt? - ANSWERMovement of blood from the right side of the heart to
the left side without picking up oxygen
Normal range for PaO2 - ANSWER80-100 mmHg on room air
Normal range for SvO2 - ANSWER60-75%
What is the most sensitive indicator of oxygenation at the cellular level? -
ANSWERMixed venous oxygen saturation (SvO2) - directly measured at the
pulmonary artery
Conditions that cause a left shift on the Oxyhemoglobin Dissociation Curve -
ANSWERAlkalosis
Low PaCO2
Hypothermia
Low 2,3-DPG
Conditions that cause a right shift on the Oxyhemoglobin Dissociation Curve -
ANSWERAcidosis
High PaCO2
Fever
High 2,3-DPG
What happens when the oxyhemoglobin dissociation curve shifts to the left? -
ANSWEROxygen does not release from hemoglobin as easily. SaO2 is higher, but the
tissues do not receive the oxygen they need.
What is 2,3-Diphosphoglycerate (2,3-DPG)? - ANSWERAn organic phosphate found in
RBCs that has the ability to alter the affinity of Hgb for oxygen
What does a decrease in 2,3-DPG lead to? - ANSWERHemoglobin holding on to O2
What does an increase in 2,3-DPG lead to? - ANSWERHemoglobin more readily
releasing O2
Factors that may lead to a decreased 2,3-DPG - ANSWERMultiple blood transfusions
Hypophosphatemia
Hypothyroidism
Factors that may lead to an increased 2,3-DPG - ANSWERChronic hypoxemia (high
altitudes, chronic HF)
