The scenario: A 50 year old male is evaluated in the emergency room (ER) for a complaint of dyspnea. The
dyspnea has become worse over many years but today is especially bad. He reports a history of smoking. His breath sounds are clear but greatly diminished throughout his lungs. ABGs, peak flow test (PF), VQ scan and chest x-ray (CXR) are completed. Results are below.
ABGs: pH 7.48, PCO2: 30, HCO3 : 24, PO2 80, SO2 94%. PF: 50% of predicted norm (ie, "low" PF). V/Q scan 0.8. CXR shows hyperinflated aveoli and air trapping.
Normal ABG ranges: PO2: 80-100 mmHg (Remember, you are supposed to know
pCO2: 35-45 mmHg pH range, SO2 range, & RR range)
HCO3: 22-26 mEq/L
13. Putting together all information given, what is the most likely diagnosis on this patient?
14. Using the "patient picture" scenario & correct answer from #13, what is the expected breathing rate & pattern of this patient?
15. What do you expect his general appearance to be like?
16. The low PF in this scenario indicates___________.
17. What acid base imbalance does this patient have?
18. The acid/base imbalance above is part of a compensatory response to keep the body
19. If you could look at this patient's lungs directly, you would expect to see _____.
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