Pulmonology

Discussion Questions:

    Explain what ARDS is.
    Explain what is significant with her lab results using the ABG normal values and the nursing mnemonic ROME which was also referenced in week #2 of this course.
    Explain what an appropriate treatment would be.

Case Study:

Mrs. Breathless is a 43-year-old female, just getting off the late shift. She reports to the ER in the early morning with shortness of breath. She has cyanosis of the lips. She has had a productive cough for 2 weeks. Her temperature is 102.2, blood pressure 110/76, heart rate 108, respiration 32, rapid and shallow. Breath sounds are diminished in both bases, with coarse rhonchi in the upper lobes. Chest X-ray indicates bilateral pneumonia.

    ABG (Arterial Blood Gases) Lab results are:         

        pH= 7.44

        PaCO2= 28

        HCO3= 24

        PaO2= 54

Note: rhonchi are continuous low pitched rattling lung sounds that often resemble snoring or wheezes.

Problems:

    PaCO2 is low.

    pH is on the high side of normal, therefore compensated respiratory alkalosis.

    Also, PaO2 is low, probably due to mucous displacing air in the alveoli affected by the pneumonia.

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