Ralphs chief complaint was dyspnea, a productive cough which has lasted for the last 3 months, fatigue, and hemoptysis. It

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Ralph’s chief complaint was dyspnea, a productive cough which has lasted for the last 3 months, fatigue, and hemoptysis. It is important to rule out international travel due to the number of diseases Ralph may have contracted while visiting, such as tuberculosis. Tuberculosis symptoms (TB) can present with chest pain, coughing up blood, and coughing. TB can cause damage to the lungs that is not cured. Ralph did state there was not any family history of any respiratory diseases, which is also an important piece of information for the doctor to have to make an accurate diagnosis.  

The normal pH of blood is 7.35 to 7.45. Ralph’s pH was 7.25, indicating his blood is too acidic.  

The normal oxygen (PaO2) in the blood is is 75 to 100 millimeters of mercury (mm Hg). The normal range for carbon dioxide (PaCO2) in the blood is 38 to 42 (mm Hg). I would say Ralph is presenting with hypoxemia. Hypoxemia is when the oxygen in your blood is lower than normal, is precisely in the arteries, and indicates an issue with circulation or breathing in a patient. His blood work also shows a raise in hematocrit, which would be due to Ralph having hypoxemia. Ralph’s Pulmonary Function Test indicated he may be suffering from COPD.  

Yes, I believe Ralph is also presenting with an infection. Ralph’s WBC count is 11,500 Leukocytosis, which is a condition that is causing Ralph to have too many white blood cells and can be caused by infections, inflammation, or tissue damage. Ralph also has a temperature of 100.5. 

I would say Ralph’s lifestyle choices and occupation have contributed to Ralph’s disease. Even though he is no longer a smoker, the years he smoked caused damaged to his lungs. Ralph working with diesel gas every day for his job, also played a role on his health.  

WC: 308