What Is The Pathophysiology Of Phillip Morris's Case Study?

Case Study: D.Q. is a 57-year-old male who worked in a water treatment plant for many years. He also smoked heavily for approximately 30 years. He has been diagnosed with COPD. During an extremely hot summer, he arrived at the emergency department in severe exacerbation of the COPD. The patient’s heart rate is 123, blood pressure is 163/90, respiratory rate is 34, oxygen saturation is 86% on 2 L NC, and temperature is 37.5 celsius.

D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years. He has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is an acute

Because the PCO2 levels are too high the body is not getting the adequate amount of oxygen. This means the oxygen-carrying hemoglobin is not working properly do to the excessive amounts carbon dioxide causing respiratory acidosis.

History of Present Illness: Mr. Olson is a very pleasant 57-year-old gentleman with multiple medical problems to include severe COPD, who is here today for an initial consultation for his shortness of breath. He is followed by a pulmonologist Dr. William Goodman, at the Veteran Affairs Administration. His last evaluation there was in February 2015. Mr. Olson states he has had ongoing dyspnea on exertion over the last two years. He complains of minimal cough. He does note some sinus problems for which he is on Flovent. In the past, he has had pulmonary function testing that did demonstrate reversible airflow obstruction, therefore he likely has some component of asthma overlay. He states that occasionally has chest tightness and chest heaviness. He has gained about 25 pounds over the last year. He is currently using Spiriva, albuterol as needed as well as Symbicort. He is also using supplemental oxygen at 2.5L per minute at night as well as on an as needed basis during the day. Mr. Olson admits to continued tobacco use with about a half pack to a pack a day. He states that when he is feeling depressed, he will smoke more.

Respiratory acidosis is a condition that occurs when the lungs cannot remove all the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic. Chronic respiratory acidosis occurs over a long period of time, this leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body’s acid-base balance. Acute respiratory acidosis is a condition in which carbon dioxide builds up quickly, before the kidneys can return the body to a state of balance. Some of the symptoms may include: confusion, fatigue, lethargy, shortness of breath, and sleepiness. Some causes of

The normal blood pH is between 7.35 and 7.45. Allen’s blood was acidotic due to a decrease in lung expansion and an alteration in the perfusion to his spinal cord. He also has an alteration in spinal innervation to the respiratory muscles including the phrenic nerve that controls the diaphragm. This would further cause Allen to not be able to adequately take in enough oxygen and blow off enough CO2 to adequately have gas exchange, within the alveoli. Respiratory failure.

The patient is 72 year old female who smokes. She complains of extreme fluid retention in lower two limbs and lower abdomen. Breathing is difficult and she is only able to sleep while sitting erect in a reclining chair.

A cousin of mine, Susan, approached me after her father received open heart surgery. Susan’s father, age 59, has been a chronic smoker since the age of 19. What went from two cigarettes a day quickly become two packs a day, with no end in sight. During July of 2015 he complained of feeling dizziness, shortness of breath,

Mr. C’s laboratory values need to be stabilized, body temperature and pulse rate decreased, blood pressure increased, weaned of the oxygen by nasal cannula an increase his urine output. Many of the signs and symptoms experienced are related to local and systemic complications of the disease process. His uncle stated that he has nausea and vomiting for the past few day and this caused many of the electrolyte imbalance (Urden, Linda D; Stacy, Kathleen M; Lough, Mary E;, 2016).

4. Anion Gap = Na - (Cl + HCO3) Anion Gap: 138- (103+16): 19 mEq/L. The anion gap reference range is 8-16 mEq/L and is elevated in this patient. The increased anion gap indicates an increased amount of unmeasured ions are present in the blood. This patient most likely has a wide anion gap acidosis, since there is decreased bicarbonate on the chemistry panel, but the clinician would have to confirm by ordering an arterial blood

Acute on chronic respiratory failure with severe hypoxemia can cause serious complications. The respiratory system is responsible for the bodies gas exchange of O2 and CO2. All the organs of the body need oxygen rich blood to function correctly. The lungs are a very delicate sponge like organ that consist of capillaries for oxygen transport and alveolar air-filled sacs. the patients have been exposed to a toxic inhalant chemical and has a history of tobacco use, this correlate with his current state of health. The patient was originally brought into an ER with his oxygen saturation at 51%, when he was stabilized he was brought to this facility.

Mr. Reeder states he is not a current smoker nor has he ever smoked. He relates his condition to be of more cardiac relation at this point. The patients pulse stayed tachycardic in did not seem to decrease even while at rest. He admitted to feeling "worn out" al the time with any activity due to the current state of his rapid heart rate. He states his activity level has decreased lately as well.

Respiratory acidosis is a condition that happens when there is too much carbon dioxide in the lungs. When this happens, the blood becomes too acidic. People with respiratory acidosis will have a pH less than 7.35 with a PaCO2 greater than 45mm HG. (sitelms.org) This particular form of acidosis can be caused by diseases of the airways, lungs, and chest. It can also be caused by diseases that may affect the nerves and muscles that tell the lungs to inflate or deflate. Certain narcotics may cause this to happen as well. If respiratory acidosis does not become too severe the kidneys will help to raise the blood pH to the normal range. The kidneys increase the amount of hydrogen it releases and the reabsorption of bicarbonate. When medical treatment is necessary, it is usually aimed at the underlying disease, or cause of the condition. (.nlm.nih.gov, 2016) Bronchodilator drugs may be prescribed to help reverse some types of

Metabolic acidosis results from all conditions that decrease the pH of the body fluids below 7.35 and HCO3- levels are <22 mEq/L, with the exception of conditions resulting from altered function of the respiratory system. As hydrogen ions accumulate in the body fluids, buffers first resist a decline in pH. If the buffers cannot compensate for the increase in hydrogen ions, the respiratory center helps regulate the body fluid pH. The reduced pH stimulates the respiratory center, which causes hyperventilation. During hyperventilation, carbon dioxide is eliminated at a greater rate. The elimination of carbon dioxide also eliminates excess hydrogen ions and helps maintain the pH of the body fluids within a normal range. (Angus, 2006)

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