Question

John is a 59-year-old man admitted to the emergency department with complaints of severe shortness of breath and a cough producing frothy, blood-tinged mucous. His history reveals a myocardial infarction 2 years ago. Since then, he has been on a low-salt diet, digoxin, and furosemide for control of congestive heart failure.

The client is admitted to the hospital for treatment of acute pulmonary edema secondary to congestive heart failure. On his fourth hospital day, the client complains of tingling and numbness of his fingers, muscle weakness, and palpitations. His electrocardiogram shows frequent premature ventricular contractions (PVCs). Four hours later, he is confused and restless.

The client’s diagnostic findings are as follows:

Arterial Blood Gases: pH 7.55, PaCO2 25 mm Hg, HCO3 34 mEq/L, PaO2 65 mm Hg, SaO2 91%

Hematology: K = 2.5 mEq/L

Questions:

What conclusions can you draw about the client’s clinical manifestations, PaO2, and SaO2 levels?

A. Analyze clinical manifestations, noting those that are reflective of oxygenation.

B. Review normal findings for PaO2 and SaO2 and compare them with the client’s levels.

C. Discuss the concepts of hypoxia and hypoxemia.

D.List possible problems related to the client’s present state of oxygenation. Consider hypoxia, acid-base balance imbalance, and so on

Answer 1

A.

The patient developed acute pulmonary oedema which results in the impaired exchange of oxygen and carbon dioxide leads to shortness of breath (partial pressure of carbon dioxide 25 mmHg(reduced), partial pressure of oxygen 65 mmHg( reduced), bicarbonate 34 mmHg(increased), oxygen saturation 91% (normal 95-100%))this is due to the amount of increased fluid in the lungs secondary to congestive heart failure. in chronic cases, the patient shows symptoms such as pink, frothy cough.

B.

	patient value	normal value
paO2	65 mmHg (hypoxemia)	75-100mmHg
SaO2	91% (hypoxia)	94-100%

C.

Hypoxia: a condition or state in which the supply of oxygen is insufficient for normal life functions.

Hypoxemia: a condition in which low arterial oxygen level.

usually, hypoxemia leads to hypoxia, in severe cases result in organ death. Cause of any type of hypoxia-like environmental or tissue hypoxia is also a potential cause of hypoxemia.

D.

• hypoxia
• acidosis (pH- 7.55)
• respiratory alkalosis
• hypoxia-induced brain injury