Question

The patient is admitted for treatment with oxygen, inhaled bronchodilators, and oral pred- nisone (60 mg/day initially, followed by a slow taper to discontinuation over 10 days). However, the patient becomes increasingly dyspneic and more agitated despite treatment. Heart rate increases to 125 bpm, pulsus paradoxus increases to 30 mm Hg, respiratory rate increases to 35/min, and breathing becomes more labored. Wheezing becomes loud through- out both inspiratory and expiratory phases of the respiratory cycle. Signs of early cyanosis become evident. The extremities become cold and clammy and the patient no longer is alert and oriented. Repeat ABG are: pH 7.35, Pao, = 45 mm Hg, and Paco, = 42 mm Hg (40% oxygen by mask).

Patient Case Question 10. Why is the patient becoming cyanotic?

Patient Case Question 11. Why has the skin become clammy?

Patient Case Question 12. What do the patient’s arterial blood gases indicate now?

Answer 1

to 12 Pa O2 = 45 mm/ity in ease of normal=1000g / PO, Paco2 =4042 mm/Hg pH = 7 on PH=7.35 30, ont indicate that there is decreasin oxygen perfusion am the body. 11) Due to exertion patient's is sal clauny.