Ventilatory Threshold Analysis

When hearing the word shock many images may come to mind as to what the word really means. People sometimes use it in a sentence when they want to describe the reaction they have to a certain situation, however, in the real world, shock can be deadly. Shock

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.

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

The stages of hypoxia Hypoxia is simply a lack of oxygen at the tissue level of the body due to a decreased partial pressure of oxygen in the inspired air. Hypoxia is serious, because it may lead to death.(2) There are four

Another follow up ABG at 0100 shows a small improvement on the Ph to 7.18, the Pco2 became more acidotic moved to 53, the Po2 improved to 77 which shows he is oxygenating better but still hypoxic, his Hco3 acidosis is improving at a change to 19.8, and sating 91% now. The Pt is now breathing at a rate has come down to 10 BPM on his own above and beyond the vent. After consulting with the physician we changed the Vt to 600 and the pressure support to 20 and Cpap to 15. The Pt continued on these settings till 0415. The physician then made the change to Bi-level with the settings of a rate of 14 pressure support of 25, and an H/L pressure of 35/15. The Pt at this time is pulling a Vt of 745 and a spontaneous rate of 17 and still at 100% Fio2 and sating 92%. This is the point when the Pt makes the turn. The Bi-level or APRV was the proper setting for this Pt. He continued to improve over the next several days with his peek pressure climbing to 40. The Pt continues these settings and slowly improves and eventually weaned from the ventilator till the Pt no longer needs support.

What are your concerns at this time? Be specific. • His Pulse ox of 94% reading is on the lower side, but still in normal range which indicated that there is less oxygen perfusion. • Brandon is 11 years of age and there is a precaution for taking beclomethasone children under 12 years

B. heart rate greater than 100 beats/minute C. hyperventilation. D. respiratory rate greater than 20 breaths/minute 13. A client who has cervical cancer is scheduled to undergo

 Assessment: the patient 's vital signs are 108/68, 125 beats per minute, respirations, even and non-labored at 14 breaths per minute, 92% on 2 liters of oxygen via nasal cannula, afebrile 98.5 F.

Peak expiratory flow rate (PEFR) is a measure of how much a person can breathe out in a single large breath. PEFR is used as a clinical tool to test the functionality of a patient’s lung, the severity of asthma or other respiratory illness symptoms and the best course of treatment for the patient. The PEFR reading will be lower when a person’s airways are constricted and should be at its highest when the patient is at full health. The PEFR is measured using a small handheld device known as a peak flow meter.

Purpose The purpose of this virtual lab is to observe the acid-base balance in the urinary system by how PCO2 and blood pH affect the H+ and HCO3- in the urine. The renal compensation is a mechanism that shows the kidneys manage to change pH in correct way if the

Nursing Diagnoses Two Primary Nursing Diagnoses The primary nursing diagnosis for this patient is impaired gas exchange, related to abnormal ventilation and perfusion ratio, as evidenced by restlessness, irritability, anxiety, decreased level of consciousness, abnormal arterial blood gases, and abnormal skin color (Gulanick & Myers, 2014, p. 82). A.C. has an endotracheal tube (ETT), and there is a note for the next day to have surgery to put in a tracheostomy. She is currently a smoker, her C02 is 74.6mEq/L which is high, her pH is low at 7.19, and the bicarbonate is 28.6mEq/L which is high. Her oxygen saturation is maintaining at 90%. Her PA02 is 56mm Hg and FI02 is 0.60. The patient is very anxious and restless in the bed, despite sedation and pain medication, and her skin is pale in color and she is diaphoretic.

- Assess the frequency and depth of breathing. Tachypnea and shallow breathing often occurs because of the movement of the chest wall and the lung fluid. -The nurse should monitor vital signs. Monitoring vital signs will enable the nurse to have a base line for further evaluation. -Auscultate the breath sounds.

Choice “C” is the best answer. This patient has an anion gap (sodium (149)- (chloride (114) + bicarbonate (15))=20) lactic acidosis (serum lactate 5.6 mmol/L) most likely secondary to an infectious etiology. He also has an elevated white blood cell count, a CT scan and X-ray suspicious for multiple nodular pulmonary infiltrates. The patient also meets criteria for severe sepsis: pulse >90 beats/minute, temperature greater than 38.0 °C, respiratory rate greater than 20/min, WBC greater than 12,000 cells/mm3 with signs of sepsis-induced tissue hypoperfusion (elevated lactate).

During my time at cardiopulmonary I didn’t do much patient interaction and treatment.There was a code (blue meaning that the patient wasn’t breathing) that was called and the therapist that I was a part of the code team. I wasn’t there for the code but I got the after math. The cardiopulmonary therapist performed an atrial blood gas test. The atrial blood gas is used to determine what gas that’s in the body that us causing the partient to have difficulty with breathing. Gases include gases such as pH (part hydrogens), levels of oxygen, carbon dioxide, and bicardinate ion. The patients blood Ph was 7.689 which is supposed to be from 7.35-7.45.

Step one of the five steps approach to interpret the above values is to look at the PaO2 level which is currently 70. Since the normal level is between 80 to 100 mm hg, the current PaO2 of 70 means Mary is experiencing hypoxemia. However, the patient’s current oxygen delivery