RSPT 2350 - Acid‑Base & Electrolyte Balance & Advanced Diagnostics

Credit Hours: 3.00

Objectives:

1. List the sites used for arterial punctures and state the benefits and hazards associated with each.
2. Describe the technique used for sampling blood from an artery.
3. Describe infection control procedures that should be followed when drawing an arterial blood sample.
4. List three possible complications of arterial punctures.

Outcome 2: Upon completion of this course, students will describe and demonstrate the proper procedure for drawing an ABG sample from an arterial line. (Module B)

Objectives:

1. List the sites used for placement of an indwelling arterial catheter.
2. Given a stopcock assembly (or diagram of one), state the proper stopcock positions to sample arterial blood and to flush the system.
3. Draw a picture of an arterial waveform and label the horizontal and vertical axis and designate the position of a dicrotic notch.
4. Define the term dampened as it refers to an arterial pressure waveform.

Outcome 3: Upon completion of this course, students will describe the effect of ventilation and perfusion on arterial blood-gas results. (Module D)

Objectives:

1. List the five types of Ventilation/Perfusion (V/Q) relationships, state how the relationship of ventilation to perfusion changes from the apices to the base of the lung and describe how West’s lung zones relate to each.
2. State how changes in cardiac output affect distribution of perfusion in the lung.
3. Explain how mechanical ventilation affects the distribution of ventilation and perfusion.
4. Distinguish between the different types of deadspace ventilation and state how each is determined and what the normal level is.
5. Distinguish between the different types of shunt ventilation and state how each is determined and what the normal level is.
6. Given a diagram of the alveolar-capillary membrane, diagram the normal driving pressures for O2 and CO2 and describe the factors that affect gas diffusion.

Outcome 4: Upon completion of this course, students will describe the process by which oxygen gets from the alveolus to the tissues of the body. List the two ways oxygen is carried in the blood and normal values of each. (Module E and F)

Objectives:

1. List the indices that are used to assess oxygenation and describe how each affect the total amount of oxygen carried in the blood.
2. Given appropriate known values, calculate the oxygen content, arterial/venous oxygen content difference, shunt fraction, arterial/alveolar oxygen ratio, and oxygen delivery.
3. List the factors that shift the oxyhemoglobin curve to the right and to the left.
4. Describe the causes of hypoxemia and hypoxia and state how each is treated.
5. Define Internal Respiration and list factors that affect the cellular oxygen supply.
6. State the formula for calculating the respiratory quotient (RQ) and describe how it is measured at the bedside.
7. List three clinical situations where hypoxia can exist without hypoxemia.

Outcome 5: Upon completion of this course, students will describe the process by which carbon dioxide is removed from the body. (Module G)

Objectives:

1. List the three ways CO2 is transported in the plasma and the three ways it is transported in the RBC.
2. Given the appropriate data, calculate the carbon dioxide content and state the normal values for each parameter.
3. Describe the relationship between PaCO2, H ions, and pH.
4. Describe the ratio of HCO3ions to H2CO3 (PaCO2).
5. Given two of the following three variables, calculate the third:
   1. PaCO2
   2. Alveolar Minute Ventilation
   3. VCO2 (Carbon Dioxide Production)
6. List ways to correct an abnormal PaCO2 level in the blood.

Outcome 6: Upon completion of this course, students will interpret and evaluate arterial/venous blood gas results with respect to oxygenation, ventilation and acid-base balance and recommend appropriate therapy. (Module A, H, I, and J)

Objectives:

1. List the normal values for arterial and venous blood gas and CO-Oximetry studies.
2. Given an ABG, interpret the results, including the degree of compensation, the degree of hypoxemia present, and any appropriate treatment.
3. List the three physiologic processes assessed with blood gas data and state how each are assessed with blood-gas or CO-Oximetry studies.
4. Define a buffer system and differentiate between the buffering systems present in the body.
5. Given an arterial blood-gas result, determine the degree of pH change that would result from an acute change in PaCO2.
6. Given a diagram of the kidney, identify the key anatomical structures and state their function.
7. Describe how the kidney maintains a normal level of electrolytes and buffers.

Outcome 7: Upon completion of this course, students will evaluate for blood gas errors and explain the effects of these errors on ABG data results. (Module C)

Objectives:

1. List the six types of arterial blood sampling errors and describe the effect of the error on the results of blood-gas values.
2. State how pulse oximetry may be helpful in distinguishing arterial from venous blood samples.
3. State the effect of increased or decreased body temperature on blood gas results.

Outcome 8: Upon completion of this course, students will correlate values obtained during noninvasive monitoring with the pathophysiology of the patient’s disease state and formulate an effective treatment plan.

Objectives:

1. Describe the function, setup, maintenance and troubleshooting of a pulse oximeter.
2. Describe the function, setup, maintenance and troubleshooting of a transcutaneous oxygen or carbon dioxide monitor.
3. Describe the function, setup, maintenance and troubleshooting of a capnometer.

1. Normal Arterial Blood-Gas Values
2. Normal Venous Blood-Gas Values
3. Gas Laws and Altitude
4. Oxygen Content
5. Arterial Puncture
6. Blood-Gas Analysis
7. Sampling Errors
8. External Diffusion
9. Oxygen Transport
10. Oxygenation
11. Ventilation
12. Acid-Base Balance
13. Renal Function
14. Non-Invasive Monitoring