02 Oct Advanced Ventilation
38576
Prompt
Case Study: Adult Respiratory Distress Syndrome History:
Ms. Y is a 23 year-old woman who was feeling fine until the morning of admission when she began having severe chills, vomiting, diarrhea, headache, and fever of 40*C. The symptoms persisted throughout the day and caused her to seek medical attention at the local ED. Ms. Y had an intrauterine device (IUD) inserted at a local family planning clinic 3 days before admission. At the time of admission, she denied shortness of breath, wheezing, sputum production, cough hemoptysis, orthopnea, chest pain, illicit drug use, or exposure to TB.
Physical Exam:
-General
Patient is well nourished, alert & oriented; she appears anxious but there is no evidence of respiratory distress
-Vital Sign:
Temp 40*C; RR 24 bpm; HR 104/min; BP 126/75
-Chest:
Normal configuration & expansion while breathing; normal resonance to percussion bilaterally
-Lungs:
Clear to auscultation bilaterally
-Abdomen:
Lower abdominal tenderness to palpation
-Extremities:
No cyanosis, edema, or clubbing
Lab Data:
-CBC
WBC 15,500 (high)
Question #1
Does the patient appear to have a pulmonary problem at this time? Why or why not?
Question #2
Does the patient’s medical problem predispose her to the development of ARDS?
Ms. Y has been started on IV antibiotic therapy. Results of a uterine swab show gram-negative diplococci, and a preliminary blood culture also shows gram-negative cocci.
Twelve hours later, she begins complaining of increased shortness of breath.
Assessment:
RR 34 bpm; HR 120/min
She is using accessory muscles to breathe and chest auscultation now reveals fine, inspiratory crackles bilaterally.
ABG: on RA
-pH: 7.25
-PaCO2: 21 mmHg
-HCO3: 16 mEq/liter
-BE: -17
-PaO2: 62 mmHg
-SaO2: 88%
Question #1
What is the pt’s acid-base & oxygenation status? Interpret the blood gas and explain your answer.
Question #2
What pathophysiology accounts for the adventitious lungs sounds (fine, inspiratory crackles)?
The patient continues to experience severe respiratory distress and is placed on an air entrainment mask with a FiO2 of 60%.
ABG on 60% FiO2:
-pH: 7.26
-PaCO2: 35 mmHg
-HCO3: 16 mEq/liter
-PaO2: 49 mmHg Assessment:
-RR 38 bpm
-HR 134/min
The chest film demonstrates an onset of diffuse bilateral infiltrates in the lower lobes; greater on the patient’s right side.
Question #1
Interpret the ABG.
Question #2
What initial settings would you place the patient on? Include mode of ventilation and indicate Why?
Submit your answers in at least 500 words on a Word document. You must cite at least three references to defend and support your position.
Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Ask A Question and we will direct you to our Order Page at WriteDemy. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.
Fill in all the assignment paper details that are required in the order form with the standard information being the page count, deadline, academic level and type of paper. It is advisable to have this information at hand so that you can quickly fill in the necessary information needed in the form for the essay writer to be immediately assigned to your writing project. Make payment for the custom essay order to enable us to assign a suitable writer to your order. Payments are made through Paypal on a secured billing page. Finally, sit back and relax.
About Wridemy
We are a professional paper writing website. If you have searched a question and bumped into our website just know you are in the right place to get help in your coursework. We offer HIGH QUALITY & PLAGIARISM FREE Papers.
How It Works
To make an Order you only need to click on “Order Now” and we will direct you to our Order Page. Fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.
Are there Discounts?
All new clients are eligible for 20% off in their first Order. Our payment method is safe and secure.