Respiratory Case A 17-year-old student has experienced reversible, periodic attacks of chest tightness with coughing, wheezing, and hyperpnea. She states that expiration is more difficult than inspiration. She is most comfortable sitting forward with arms leaning on some support. Chest X-rays revealed mild overinflation of the lungs. Results from laboratory and pulmonary function tests are as follows: 20 breaths/min Frequency Vital capacity (VC) 2.9 L FEV1.0 1.4 L FEV1.0/FVC 56% Functional residual capacity (FRC) 3.89 L Total lung capacity (TLC) 6.82 L Pa02 70 mm Hg РаСО2 26 mm Hg Pulse 108 b/min ВР 120/76 mm Hg Intermittent use of a bronchial smooth muscle dilator (1:1000 epinephrine by nebulizer) for several days caused marked improvement

Respiratory Case A 17-year-old student has experienced reversible, periodic attacks of chest tightness with coughing, wheezing, and hyperpnea. She states that expiration is more difficult than inspiration. She is most comfortable sitting forward with arms leaning on some support. Chest X-rays revealed mild overinflation of the lungs. Results from laboratory and pulmonary function tests are as follows: 20 breaths/min Frequency Vital capacity (VC) 2.9 L FEV1.0 1.4 L FEV1.0/FVC 56% Functional residual capacity (FRC) 3.89 L Total lung capacity (TLC) 6.82 L Pa02 70 mm Hg РаСО2 26 mm Hg Pulse 108 b/min ВР 120/76 mm Hg Intermittent use of a bronchial smooth muscle dilator (1:1000 epinephrine by nebulizer) for several days caused marked improvement

Basic Clinical Lab Competencies for Respiratory Care: An Integrated Approach

5th Edition

ISBN:9781285244662

Author:White

Publisher:White

Chapter18: Bronchoscopy Assisting

Section: Chapter Questions

Problem 2SEPT

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S.M. is a 25-year-old man in the clinic today for worsening shortness of breath. He smoked one pack of cigarettes per day from ages 18-20, but states he has not smoked in 5 years. Physical examination reveals a thin man in moderate respiratory distress. There is marked increase in the anteroposterior diameter, distant lung sounds, and occasional expiratory wheeze. Blood gases on room air are as follows: pH 7.42, PaCO2 40, PaO2 71, HCO3- 26. Select a potential diagnosis for S.S. and describe the pathophysiology of that diagnosis. How does the pathophysiology explain S.S.’s physical exam and lab findings?
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State 4 diagnostic tests for respiratory conditions and 4 signs and symptoms associated with respiratory conditions
LF, a 34 year old white male, presented to the emergency room complaining of acute and severe shortnessof breath and intense chest tightness. LF’s speech was choppy and breathing was very rapid and erratic,punctuated by noticeable wheezing. LF’s medical records included the results of pulmonary functiontesting he had undergone six months before (Table 1).Table 1. Pre- vs post-bronchodilator spirometry at baselinePre-Bronchodilator (L) Post-Bronchodilator (L) Predicted Normal (L)FEV1 3.22 4.25 5.55FVC 5.20 5.52 6.51His medical records also indicated prior admission for respiratory symptoms and a history of poorly-controlled asthma. Blood gas tests were performed shortly after LF was admitted (Table 2) and a PEFR(peak expiratory flow rate) test performed. The latter revealed a PEFR of 181 L/min (normal: 525 L/min).LF additionally had serum creatinine measured at admission and at 12h post-admission (Table 3).Table 2. Blood gas values upon admissionAdmission + 2h +4h +6h +8h +10h +12hPaO2…
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P.R., a 61-year-old woman who has no history of respiratory disease, is being admitted to your unit with adiagnosis of pneumonia and acute respiratory failure. She was endotracheally intubated orally in the emergency room and placed on mechanical ventilation. Her vital signs are 112/68, 134, 101° F (38.3° C) with an Sa O2 of 53%. Her ventilator settings are synchronized intermittent mandatory ventilation of 12 breaths/min (BPM), tidal volume (V T ) 700 mL, Fi O2 0.50, positive end-expiratory pressure (PEEP) 5 cm H 2 O. CHART REVIEW: Arterial Blood Gases pH 7.30 PaCo2 52 mm Hg HCO3 22 mmol/L PaO2 70 mm Hg SaO2 88% 7. ABGs are redrawn after P.R. is on mechanical ventilation for 1 hour. What ventilator changes do you anticipate, based on your interpretation of these values? (Select all that apply, and explain your rationale.) a. Increasing the PEEP to 10 cm b. Increasing the rate on the ventilator to 16 breaths/min c. Increasing the tidal volume…
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Clinical terms for variations in respiratory rhythm are listed in the boxes below. Place each term in the proper location to identify the combination of factors (e.g. volume and rate) that characterizes each condition. Respiratory Kussmaul Нyperpnea Tachypnea Hypoventilation Apnea arrest respiration High intensity exercise Eupnea Rate of breathing 47 of 60 Prev Next> Volume of breathing
Case one Respiratory issue After traveling by air from Romania to New York, a 35-year-old woman develops a sudden onset of chest pain and shortness of breath. She has not experienced anything like this before, but her sister had a similar episode after the delivery of her first child. On examination, the patient appears anxious and tachypneic. Her lungs reveal good air movement bilaterally. Questions What is the most likely diagnosis? What are the possible underlying mechanisms? What are the risk factors?