Cari's Story a&P 2

PCO2 decreased during rapid breathing because more CO2 was removed from the blood than normal. Each breath expels a certain amount of CO2. If the breathing rate increases, then more CO2 is expelled.

A low partial pressure of oxygen (PaO2) suggests that a person is not getting enough oxygen; Metabolic acidosis->Kidney failure, shock, diabetic ketoacidosis

B. The muscles that help move air in and out of the lungs are severely compromised.

6. Your patient has a respiratory disease that has literally paralyzed the cilia. Explain why this patient would be at an increased risk for a respiratory infection. What type of treatment might you want to give to this person? Please be specific.

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

Since Cari is a smoker, cigarette smoke has paralyzed her cilia and stimulated the goblet cells lining her respiratory passages to secrete excess amounts of mucus. Ducts from the sinuses open into the internal nose providing a passageway for microorganisms to travel into the sinuses.

2. Can you draw a diagram that shows how the respiratory system, under the control of the central

An infection would spread into Cari’s sinuses due to the sinuses being a drainage area for the nasal passage.

2. Upon admission to the hospital, Allen’s breathing was rapid and shallow, can you explain why? Pg. 969

I think Sally is experiencing metabolic acidosis, and the respiratory response is hyperventilation which increases loss of CO2 hence the reason she is breathing deeply and gasping. Also, if compensation is complete, pH will be within normal range but HCO3- will be low.

Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or

Did the pH level of the blood change at all during this run? If so, how? Yes it did, when the breathing

Cigarette smoke also paralyzes cilia necessary to move mucus up the airways. With enough exposure, the cilia can actually be destroyed.

pneumoniae and there chemotactic signals and the host cell’s alternate pathway, invade the alveoli. Also red blood cells are recruited to this site. In the third stage, mostly neutrophils are packed into the alveoli and very few bacteria remain. In the final stage, macrophages eliminate the remaining residue from the inflammatory response. As one can see, the damage which is done to the lung is largely a result of the host’s inflammatory response, which causes the build up of fluids in the lungs. If S. pneumoniae is allowed to persist in the lungs it can then invade the blood, which causes bacteremia. When in the blood it can traverse the blood-brain barrier and infect the meninges, which results in meningitis. S. pneumoniae is also associated with diseases in other parts of the respiratory tract including the paranasal sinuses, which is better known as sinusitis, and the middle ear can become infected, which is known as otitis media. It has also been known to cause peritonitis, an inflammation of the peritoneum, the membrane that lines the abdominal wall, and it is also implicated in causing arthritis.

Respiratory Acidosis occurs when the lungs cannot remove all the carbon dioxide that the body makes. In turn this makes fluid in the body become too acidic. The distinctive feature of respiratory acidosis is an abnormally high PCO2, meaning above 45 mmHg. Improper exhalation of oxygen can cause the blood pH to drop.” Any condition that decreases the movement of CO2 from the blood to the alveoli of the lungs to the atmosphere causes a buildup of CO2, H2CO3, and H+ (Tortora, 2014, p.1036)”. Symptoms of this condition may include: confusion, lethargy, fatigue, sleepiness, and shortness of breath. Probable causes are: obesity, disease of the chest, diseases of the lungs and airways, and drugs that suppress breathing (MedlinePLus, 2012). A health care provider will perform a physical exam to see if this is what is happening. He may do so by: arterial blood gas which measures oxygen and carbon dioxide levels in the blood, basic metabolic panel, a chest x-ray, or possibly a pulmonary function test (MedlinePLus, 2012). Treatment is mainly aimed at the underlying cause not at condition itself. It is treated