Question

which patients are experiencing problems with ventilation? Explain your answer.

Ratagraph Use your own words only. 1) Winter is a 4-year-old girl with a history of asthma. Her mother has brought her in an "asthma attack". Winter is sitting in her mother's lap and breathing rapidly through an open mouth. She has a cough that sounds congested and wheezy. The physician has already ordered a nebulized treatment containing albuterol (Proventil) and ipratropium bromide (Atrovent). 2) Mr. Chung is a 68-year-old man complaining of cough, sore throat, fatigue, and weakness His BP is 166/82, pulse is 90, respirations are 26, and temperature is 100.4 degrees. 3) Jackson is a 19-year-old man who has had a sudden onset of right-sided chest pain and shortness of breath. His chest x-ray film revealed a right pneumothorax, and he is currently receiving 35% oxygen by face mask while waiting for an ambulance to transport him to the hospital for further evaluation. 4) Ms. Summers is a 45-year-old homemaker. She says she has been extremely tired, easily becomes short of breath, and is unable to complete her chores without frequent rest breaks. She is pale and seems tired. Her vital signs are as follows: BP 136/78, pulse 86, respirations 24 and unlabored; temp 98.4 and pulse oximetry 98% on room air. She is now waiting for her lab results, which include a complete blood count (CBC) f. M Answer the following questions that pertain to the above patients. a Which patients are experiencing problems with ventilation? Explain your answer b. Which patient appears to be experiencing problems with hypoxia? Does the problem appear to be related to oxygenation or perfusion? Explain your answers. e Mr Chung has smoked two packs of cigarettes per day for 50 years. ABGS reveal a low PO2 and a high PCO2 consistent with chronic lung disease. Heis diagnosed with an acute exacerbation of chronic bronchitis. He is placed on oral antibiotics and long acting bronchodilators by metered dose inhaler (MDI). What teaching could you offer to help Mr. Chung mobilize and expectorate secretions? Page t of 2 Wordi: 467 EnglishUSI acer

Answer 1

Which patients are experiencing problems with ventilation?

Patient winter and Jackson is experiencing ventilation problems because winter has Asthma which is a condition characterised by narrow airway and increased mucus caused by inflammation of the airway tissue ,bronchi or alveolus which causes shortness of breath and wheezing which can cause hypoxia and impaired gas exchange .Mr Jackson has pneumothorax which means there is an air leak into the pleural cavity from the chest wall die to trauma or bullae rupture .generally our pleural cavity is in negative pressure with respect to Atmosphere which causes ventilation or gas exchange from high pressure area to low pressure area .do when the air leaks from chest wall to pleaural cavity it reduces the vital capacity .The air leaks continues till there is no pressure difference.This space for air transfer is taken by again collapsing the lungs and congesting the thoracic cavity which again causes reduced vital capacity which causes low ventilation perfusion in turn causes hypoxia .so both these patients experience ventilation problems due to reduced vital capacity and bronchial constriction.

The other two patients Mr Chaung has fever with cough and sore throat his respiratory rate is normal with 26b/m which shows that he is breathing appropriately with no hypo or hyperventilation .Ms Summers also has a respiratory rate of 24b/m which is not labored and saturation of 98% on room air which shows that she also does not show any breathing difficulty.Mr Chaung may be having an infective sore throat or viral fever and Ms Summers looks like having anemia since she is having tiredness and shortness of breath .