The inspection revealed a barrel chest, clubbing of his fingers and toes, cyanotic skin, and pitting edema (2+) around his ankles. His breathing was labored; he was pursed-lip breathing, using his accessory muscles of respiration, and he appeared weak. He had a frequent weak cough productive of large amounts of thick, yellow sputum. Vital signs were as follows: BP 190/115, HR 125 bpm, RR 30 breaths/min, oral temperature 37 ° C. Tactile fremitus was present over both lung fields, and hyperresonant percussion notes were produced both anteriorly and posteriorly. Bilateral rhonchi were auscultated. His abdomen was soft and not tender. Bowel sounds were active. On room air his arterial blood gas values were as follows: pH 7.53, PaC02 56 mmHg, Pa02 64 mmHg, HC03 33 mmol/L. review of his chart showed that on his last hospital discharge, his baseline ABG’s on 2 L/min 02 were as follows: pH 7.39, PaC02 85, mmHg, Pa02 64 mmHg, HC03 38 mmol/L. His carboxyhemoglobin level was 6%. His chest x-ray on this admission showed severe hyperinflation with depressed hemidiaphragms (refer to page 183 for reference). No acute infiltrates were apparent. His heart size was normal. His CBC values were all normal except for hct of 58% and hgb of 16.5. The attending physician ordered a respiratory care consult. The following order was written in the patient’s chart: "All efforts should be made to keep the patient off the ventilator.
A. Classify his baseline ABG.
B. Classify his current ABG.
C. Using the terms from of your Respiratory Disease, which term would be used to describe his current ABG?
Answers: 2
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The inspection revealed a barrel chest, clubbing of his fingers and toes, cyanotic skin, and pitting...
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