Acute Respiratory Failure Caused By Aspiration Pneumonia

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Acute Respiratory Failure Caused by Aspiration Pneumonia

My patient is a 47-year-old female who was admitted into the University of Kentucky hospital on September 9th, due to acute respiratory failure with hypoxemia. She was in respiratory distress and had an altered mental status. Her chief complaint was shortness of breath.
Her medical history showed a history of strokes with left hemiparesis/aphasia, seizures, hypertension, chronic systolic and diastolic dysfunction, mechanical aortic valve replacement, depression with psychosis, nephropathy, and GERDS. She currently resides in a skilled nursing facility. 
 Initial assessment of my patient revealed she had an increased work of breathing using accessory muscles she had a fever of 39 degrees Celsius. Vital signs included, respiratory rate 31, blood pressure 130/85, breath sounds were diminished with crackles in the bronchioles. Chest physical examined revealed increased fremitus and a dull percussion note.
After arriving at the emergency department at U.K. hospital, my patient reported to having choked while eating breakfast on 9/7/16. She also mentioned that she frequently chokes while eating, so this was not a surprise to her. She reported that she had another spell with pneumonia previously this year as well as having difficulty breathing. She was placed on a bipap with 100% FIO2, with some improvement of the hypoxia. Her sats were 86%. She was switch to a NRB mask at 100% FiO2. After the change in oxygen
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