Explain The Five Steps Of Correcting The Pao2 Level

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

Another important intervention was to maintain the head of the bed at 30-45 degrees and position L.M.’s left lung into a dependent position to improve ventilation and perfusion. L.M.’s O2 was decreased to 63 and her CO2 was increased to 50. According to the IHI, it is recommended to elevate the bed to 30- 45 degrees to improve ventilation. Patients that lay in the supine position have lower spontaneous tidal volumes on pressure support ventilation compared to those laying at more of an angle (Institute for Healthcare Improvement, 2012). In regards to positioning, when the least damaged portion of the lung is placed in a dependent position it receives preferential blood flow. This redistribution of blood flow helps match ventilation and perfusion, therefore, improving gas exchange (Lough, Stacy & Urden, 2010). Implementing these interventions combined with respiratory therapy, significantly improved the blood gas values for oxygen and carbon dioxide levels.

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

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,

The Ventilatory threshold was reached at 5 minutes or stage 3 for patient 92 C. The ventilatory threshold is important because it indicates the point at which the blood lactate acid increases non-linearly. It indicates that there is an increase in the lactate acid level in the blood as well as the excess carbon dioxide (Kenny et al., 2015). The increase in carbon dioxide will stimulate chemoreceptors to increase ventilation. The ventilatory threshold is related to the anaerobic threshold which refers to the increase in carbon dioxide and indicates that the body has shifted towards anaerobic metabolism (Kenny et al., 2015).

and the pulse oximeter reading is at 88% room air, so the physician ordered 2 to 4 L of

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.

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

“Put her on 6 liters of oxygen,” I answered more confidently. As I reassessed my patient, I noticed she was breathing easier. Her oxygen saturation was now 98%. I checked her fingernail beds and lips, and the blue tinge I had noticed earlier had disappeared. I lifted her hands slightly to show the medic. He gave me a thumbs up.

Dr. Jackson called back around 4:40 a.m. and ordered supplemental oxygen, blood work, and diuretic, and to maintain the patient’s oxygen saturation reading above 94 percent. Around 5:30 a.m., the patient’s respiration was still labored with 36-40 breaths per minute. Obeyesekere once again suctioned the patient that brought the patient’s oxygen saturation level at 95 percent. Meanwhile, at 5:30 a.m.,

Marie is pale, weak, and anxious, but no longer disoriented. Her fundus is firm and is 1 cm above the umbilicus. She is receiving O2 per nasal cannula at 4 liters/minute and has an O2 saturation of 88%. Her vital signs are: BP 74/44, pulse 116 and respirations 26. Her bleeding has slowed considerably. The nurse asks the UAP to bathe Marie and change the bed linens.

The most serious health problem that the client has is impaired gas exchange. According to Sue Galanes (2007), impaired gas exchange is result from the balance between ventilation and perfusion is offset by a certain condition which affects the efficiency of the gas exchange. On account of client has congestive heart failure that can contribute to dyspnea, which means the efficiency of gas exchange is decreased. One of the significant defining characteristics of impaired gas exchange is dyspnea (Sabtu, 03 Agustus 2013). In addition, it was hard for the patient to talk in long sentence due to difficulty in breathing. Hence, impaired gas exchange is one of the health problems that the client suffered from. In regards of O2 is the basic element that all of cells and organs need, it can be considered as a fuel of human body. Therefore, impaired gas exchange is the most severe health problem the patient has currently.

Ht: 62”, Weight: 134 pounds, BMI: 24.5 Temp 98.4 BP 128/90 P 76 R18, even. The Oxygen saturation 98%.

After being reminded by the instructor, I was aware of my mistakes and noticed that I failed to maintain patient’s safety. An oxygen below 90% can be very dangerous for the patient, especially for a post-op day #1 patient, because prolonged hypoxemia can cause fatigue, headache, acute respiratory failure, cardiac problems (increased heart rate,

Two wide bore cannula, were inserted and a full set of bloods was taken including blood cultures. 15 litres O2 via a rebreather mask was applied. Intravenous fluids were commenced and rapidly infused. An ECG was done by the intern. She was checked and rechecked for any signs of bleeding and an internal examine was done by the consultant to check for any retained products. Intravenous antibiotics were also started and given. All drugs such as anaesthetic drugs or analgesia that Susan had been given that day were also checked to see if it had been an adverse reaction. Over the next 40 minutes she began to improve and was transferred to the labour ward for closer observation.