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Question

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 finished 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?

pls with the references. Thanks

Top Answer

The ABG results are considered abnormal. pH is 7.491 which is elevated. Normal range is 7.38 to 7.42 pCO2 is 27.6 which is... View the full answer

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