Mitzi Winston, 28 yof, was admitted last night for weakness and what appears to be ascending muscle paralysis. Patient is alert and oriented.
P 96, regular, BP 134/82 temp. 37C, RR 24 and shallow. BS decreased, chest expansin is equal but decreased. NPC.
ABG on RA ph 7.46 CO2 39 O2 76 Sat 96% HCO3 26 Hgb 14.6 WBC 9400
The attending physician asks you for respiratory therapy recommendations. What would you suggest be ordered? Why?
The patient may be a case of gullain bairre syndrome so there can be paralysis of nerves controlling inspiratory or expiratory muscles which can lead to respiratory failure .respiratory therapy recommendations like fowlers position of the patient to facilitate proper lung expansion and postural drainage for secretion management may be ordered. Ventilation status should be regularly monitored like pulse oximetry and vital capacity.
Mitzi Winston, 28 yof, was admitted last night for weakness and what appears to be ascending...
Duke Lukela, 42yom, admitted for flare of silcosis. Patient alert and oriented. HR 96, BP 130/90, RR 26 shallow. BS decreased. NPC. ABG-ph 7.42 PaCO2 30 O2 58 HCO3 19 Sat 82 on NC at 2lpm Hgb 16.4 WBC 10,600 Orders: increase oxygen to 5 lpm and give Atrovent 2 puffs Q 6 hours Would you implement the order as it is written? What would you recommend in its place? Would you add or delete anything from this order? Why...
Bronco Lane, a 58 yom admitted this am with acute dyspnea secondary to pulmonary fibrosis. Patient is alert and oriented. P 120, BP 146/90, temp. 39C RR 28 shallow and labored. BS decreased with crackles. Patient is not coughing. On RA-ph 7.52 PaCO2 30 O2 42 HCO3 24 SAT 80% Hg 7.2 WBC 9400 Please order test and make recommendations to treat this patient.
Hans Lipper, a 44yom, was admitted this morning with a fever, chills, and substernal pain; histoplasmosis is suspected on the basis of exposure to appropriate condtions. Patient is alert and oriented. Has peripheral IV. HR 106, BP 138,/60, temp. 38.4C RR 24 slightly labored. BS decreased, bases with crackles on inspiraton, occasional cough often productive. Chest x-ray diffuse patchy parenchymal densities. pH 7.48 pCO2 32 PaO2 60 Sat 93 HC03 24 on RA Hgb 13.8 WBC 12, 600 The attending...