Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but does get short of breath easily. There are no known ill contacts at home. Her family history includes significant heart disease and prostate malignancy in her father. Social history is positive for smoking tobacco use at 30 pack years. She quit smoking 2 years ago due to increasing shortness of breath. She denies all alcohol and illegal drug use. There are no known foods, drugs, or environmental allergies. Physical Exam Initial physical exam reveals temperature 97.3 F, heart rate 74 bpm, respiratory rate 24, BP 104/54, BMI 40.2, and O2 saturation 90% on room air. Pulmonary/Chest: No respiratory status distress at this time, tachypnea present, (+) wheezing noted, bilateral rhonchi, decreased air movement bilaterally. Patient barely able to finish a full sentence due to shortness of breath. ABG: Initial arterial blood gas with pH 7.491, PCO2 27.6, PO2 53.6, HCO3 20.6, and oxygen saturation 90% on room air.
1. What is your interpretation of the ABG results?
2. Based on the findings, what is the clinical diagnosis?
3.What medication would you anticipate the health care provider ordering?
4. What is the difference between Bipap and CPAP?
1. arterial blood gas- pH 7.491, PCO2 27.6, PO2 53.6, HCO3 20.6, and oxygen saturation 90% on room air.
Blood pH is in the alkaline range pH 7.491
This is caused by a decrease in PCO2 27.6(Is in alkaline range), Here HCO3 ( I.e 20.6) is in acidic range because it is compensating to respiratory alkalosis.
This is due to Hyperventilation(Carbon-dioxide wash out)
The PO2 is 53.6 because of decreased air entry to the lungs.
2. Diagnosis is COPD (Chronic obstructive pulmonary disease)
ABG showing Respiratory alkalosis
3. The health care provider should first order Bronchodilator to increase air entry, it also can help to reduce shortness of breath.
Steroids can be given.
4. BiPAP (Bilevel positive airway pressure) and CPAP (Continuous positive airway pressure) are almost the same in function.
The only difference is BiPAP has two pressure setting 1. During Inspiration, Inspiratory positive airway pressure (IPAP) 2. During Expiration, Expiratory positive airway pressure (EPAP)
Read the case study. Then answer the questions at the end of the case study. The...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
Read the case study. Then answer the questions typed at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production...
Read the case study. Then answer the questions at the end of the case study. The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but...
The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but does get short of breath easily. There are no known ill contacts at home. Her...
The patient is a 60-year-old Caucasian female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping. She denies fever, chills, cough, wheezing, and sputum production but does get short of breath easily. There are no known ill contacts at home. Her...