Please answer all parts
Brian, an 80-year-old man with a history of chronic obstructive pulmonary disease (COPD) and respiratory infections, was admitted through the ER with a chronic cough and extreme dyspnea. He complained that he was unable to climb the stairs or anything that required any exertion (even washing his hair). He had been a heavy smoker, but had been attempting to stop smoking by cutting back on the number of cigarettes per day. The nurse noted his temperature was 101.2 °F.
Arterial Blood Gas Results
Test |
Brian |
Reference Range |
pH |
7.23 |
7.35–7.45 |
PCO2 |
75.0 |
35.45 mm Hg |
PO2 |
28.2 |
83–108 mm Hg |
HCO3 |
32.7 |
22–28 mEq/L |
SaO2 |
49.6 |
95–98% |
COHb |
8.6 |
Nonsmoker: 0.5–1.5% Smokers: 1–2 packs/day:4–5 % > 2 Packs/day:8–9% |
Primary compensatory mechanism:
**When there is alveolar hypoventilation there will be
Co2 retention..This is due to COPD for this patient..this time PH
value will be less,PCO2 increase,HCO3 increase with
compensation..Reabsorption of HCO3 by the proximal convoluted
tubules increase and it increase the H+ as H2PO4,and
NH4+ by the distal convoluted tubule and collecting
duct..
Oxyhemoglobin dissociation curve:
** Many physiological factors associated with oxygen dissociation
curve either left or right side..unloading oxygen compared to
normal curve at the oxygen tension it show rightward shift..If more
oxygen loaded it show leftward shift..In this case there is
carbondioxide tension made PH less(acidity) and increased 2,3-DPG
and increase in temperature shift the curve rightward..
Base excess and base deficit:
** Base excess(BE) in acid base status it measure
non-respirator(metabolic)component of acid-base balance. Abnormal
base excess indicate metabolic acidosis or metabolic
alkalosis..Negative base excess referred to base deficit(BD)..In
respiratory acidosis it increase paco2 and reduce PH ,Pco2 increase
>45mmHg..so base excess will be normal by (-3 to +3mmol/l) but
its utility in interpreting blood gas results in controversial..The
Alkalaemia or Acidaemia may be primary or secondary to respiratory
acidosis or alkalosis..In this case base excess does not take any
appropriate action of metabolic response,it limits its utility when
interpreting results..
condition associated with acid-base disorder:
** patient present to the hospital with chronic cough and extreme
dyspnea and known case of COPD and respiratory infection..this
indicate decreased air movement in the lungs..It is the condition
that occur when the lungs can not remove enough co2 due to
obstruction (COPD), due to this excess CO2 in the lungs make PH of
blood and other body fluid to decrease,making them too acidic..
Please answer all parts Brian, an 80-year-old man with a history of chronic obstructive pulmonary disease...
Brian, an 80-year-old man with a history of chronic obstructive pulmonary disease (COPD) and respiratory infections, was admitted through the ER with a chronic cough and extreme dyspnea. He complained that he was unable to climb the stairs or anything that required any exertion (even washing his hair). He had been a heavy smoker, but had been attempting to stop smoking by cutting back on the number of cigarettes per day. The nurse noted his temperature was 101.2 °F. Arterial...
Brian, an 80-year-old man with a history of chronic obstructive pulmonary disease (COPD) and respiratory infections, was admitted through the ER with a chronic cough and extreme dyspnea. He complained that he was unable to climb the stairs or anything that required any exertion (even washing his hair). He had been a heavy smoker, but had been attempting to stop smoking by cutting back on the number of cigarettes per day. The nurse noted his temperature was 101.2 °F. Arterial...
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