scroll to top
Stuck on your essay?
Get ideas from this essay and see how your work stacks up
Word Count: 2,950
Directions The following exam consists of various types of questions designed to test the critical reasoning skills of the examinee Answers are found on the following page with rationales This is a Twenty question test with an allotted time of 45 minutes to indulge ones academic and clinical prowess Questions 1-4 are based on the following scenario A 55 year old male medium body build of 90 Kg presents complaining of acute shortness of breath He has a history of CHF and acute respiratory failure he is agitated and disoriented He has been placed on a ventilator two times during the past year His medications include HCTZ captopril digoxin and lasix Paramedics have placed him in 100 O2 via Non-rebreathing mask established an IV and administered 40 mg of Lasix IV enroute He is cold pale and diaphoretic with a BP of 200110 HR 120 RR 48 rales are audible througout ABGs are drawn and the results are pH - 73 PCO2 55 HCO3 24 PaO2 60 1 Why is this gentlemans PCO2 elevated a Not enough total ventilation CNSRespiratory muscle weakness bToo much total ventilation Dead Space Rapid breathing1 d - The only reason for elevated PCO2 is an inadequate level of alveolar ventilation for the amount of CO2 produced and delivered to the lungs Hypercapnea in this case is a combination of both Since he is tachypneic his respiratory muscles are tiring he is displaying mental status changes do to hypercarbia effects on the CNS Because his RR is 48 he much of his VT ends up as alveolar dead space2 Why is this gentlemans PaCO2 of concern to you clinicallya Increased PaCO2 if no compensatory increase in HCO3 results in fall in pHb Increased PaCO2 results in a decrease in PaO2 unless FiO2 can increase enough to compensatec The higher the PaCO2 the less well defended this pt is against a further decrease in VAe His PaCO2 in this case
@Kibin is a lifesaver for my essay right now!!
- Sandra Slivka, student @ UC Berkeley
Wow, this is the best essay help I've ever received!
- Camvu Pham, student @ U of M
If I'd known about @Kibin in college, I would have gotten much more sleep
- Jen Soust, alumni @ UCLA