Respiratory acidosis (respiratory failure/ventilator failure) is an acid based disturbance characterized by abnormally high amounts of carbon dioxide gas dissolved in systemic arterial blood, above 45 mmHg (millimeter of mercury) and a deviation of pH away from the normal value of 7.4. The elevation in PCO2 has been never due to an increase in CO2 production. (Angus MD, 2006). Other causes include the presence of excessive carbon dioxide in inspired air (inhaled breath). Decreased alveolar ventilation (exhaled breath).…
Q1. What clinical findings are likely in R.S. as a consequence of his COPD? Ans. The clinical findings are likely in R.S. as consequences of his COPD are SOB, history of smoking, thick sputum and sputum may be purulent, productive cough, wheezing, rhonchi and decreased breath sounds, dyspnea, chills, muscle aches, fatigue may be evident during meals, when walking and even after rest.…
Let it Blow Respiratory Case Study Elijah Stevens is 74 year old male with a history of COPD. He is admitted to the hospital for an exacerbation of his COPD. He continues to smoke cigarettes (reports one pack a day). His current medications include theophylline, albuterol inhaler, beclomethasone dipropionate inhaler and a chewable aspirin 81 mg once a day.…
Ms. [Name] returns with some shortness of breath with exertion, and purulent bronchitis. She does have a history of asthma. She has not used her inhalers recently. Her past medical history is otherwise unremarkable. She is not 77.…
Even though specific treatment does not be present, acute respiratory distress syndrome, treatment of the underlying condition is not therapy, it is essential to use non-invasive ventilation or mechanical ventilation with low tidal volume and conservative fluid management. Since the infection often the cause of ARDS, early administration of suitable antibiotics as wide to cover the suspected agents is essential with a careful evaluation of the patient in order to determine a potential infection source. Sepsis related ARDS is in some cases since it is not solved without control, removal of the blood vessel lines of the infected site, infection drainage of fluid collections, or from surgical debridement or ablation (for instance, ischemic sheet) may be necessary. It may also include deep vein thrombosis, for preventing long-term mechanical ventilation and ICU stay and related complications (DVT) prevent, minimize the prevention, early mobilization, sedation of stress ulcer rotation and skin care, and altitude such as artificial strategy, the head of the bed and using gates suction mechanism to prevent pneumonia caused by respiratory tract. ARDS patients are on bed rest.…
Based on the laboratory tests provided, it can be determined that the unknown organism can be identified as Pseudomonas aeruginosa (P. aeruginosa). This organism is an opportunistic pathogen that can infect non-mammalian, plants, and humans. P. aeruginosa belongs to the bacterial family Pseudomonadaceae, and is a gram-negative rod that approximately measures 0.5 to 0.8 µm by 1.5 to 3.0 µm. It can normally be found in water and soil. Its single polar flagellum makes it motile, and it is known to be one of the fastest swimming bacteria found in hay infusion and pond water (Crittenden, Trussell, Hand, and Howe 2012).…
PONV has a significant impact on the patient and on the healthcare facility. Healthcare facilities are seeing increased costs related to PONV due to the resulting complications, unanticipated admission, prolonged nursing care, and delayed PACU or hospital discharge (Kovac, 2013). Not only is PONV a huge patient dissatisfier, there are life-threatening risks associated with this complication including aspiration pneumonia, esophageal rupture, subcutaneous emphysema, and bilateral pneumothoraxes (Hambridge, 2013). In a study completed by Parra-Sanchez et al. (2012), it was determined that the cost of care for patients that experienced PONV was approximately seventy-five dollars more expensive compared to patients who did not experience PONV.…
In these cases, aerosolized anti-infective agents and/or systemic antimicrobial agents may be necessary. A lot of care must be taken by physicians and therapists to make sure that the agents used are appropriate for the patient’s condition since improper diagnosis can lead to limited or no positive effect on patient’s disease. In the following paragraphs I will summarize the main anti-infective and antimicrobial agents used in respiratory care and how we determine which is appropriate.…
This case study will explore the management of a complicated case of acute respiratory failure. The key aspects that will be discussed within this essay will be addressed ethically with emphasis placed on maintaining patient confidentiality. Firstly, this essay will include an overview of Mr Jones condition, relevant history and a brief discussion of his symptoms and assessment findings. Secondly, the anatomical and pathophysiology of the respiratory system will be analysed and the interrelationship between the clinical characteristics and pathophysiological mechanisms of respiratory failure will be identified. Lastly, the pathophysiological processes of respiratory failure will be critically analysed and with the use of evidence based literature, linked to the clinical presentation of Mr Jones.…
Sepsis and its consequences are one of the leading causes of death in Intensive care units (ICUs)[1, 2]. Prompt diagnosis and administration of appropriate antimicrobial therapy are essential for reducing complications associated with sepsis-related organ failure. However, sepsis response is complex and not all patients with infections display related signs or symptoms. The early detection of those patients showing an initial unfavorable course or with an increased mortality risk is essential in order to prevent the progression of organ dysfunction, which would increase the frequency of complications and patient mortality.…
• A 2016 SCCM/ESICM task force has defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection: Gram positive bacteria are most frequently identified in patients with sepsis in the United States • Risk factors for sepsis include, intensive care unit (ICU) admission, a nosocomial infection, bacteremia, advanced age, immunosuppression, previous hospitalization (in particular hospitalization associated with infection), and community-acquired pneumonia. • Sepsis being identified early, using qSOFA criteria, a modified version of the Sequential (Sepsis-related) Organ Failure Assessment score (SOFA) can contribute to the decrease of sepsis-associated mortality. The main purpose is to identify the potential…
Healthcare associated infections (HAIs) are a worldwide patient safety issue. HAIs are defined as infections that patients can get while receiving treatments in healthcare settings (CDC,2014). Central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI) and surgical site infection are known as most common types of HAIs (CDC, 2014). 30% of intensive care unit (ICU) patients are affected by one HAI (WHO, n.d). Despite the great progress on reducing some infection types, there is still much effort needing to be accomplished (CDC, 2016).…
Pathophysiology of pneumonia can vary depending on the offending organism, some viruses may cause direct injury or even cell death, although many organisms may only trigger an inflammatory in the lungs. Increase in blood flow may be triggered by a vascular reaction, and regulation of vascular permeability. In a medical situation such as pneumonia, the neutrophils are activated to help fight the infection by digesting microorganisms and releasing enzymes that would destroy the microorganisms (Brown, 2013). Fluid from surrounding blood vessels, the neutrophils and the offending microorganism fill the alveoli and disturb normal oxygen transportation resulting in signs and symptoms of hypoxia, shortness of breath, (a symptom expressed in Roberts diagnose). With the increase of mucus, the obstructed airflow and with further decrease of gas exchange, thereby normally air-filled alveoli become filled with debris and fluid, this would all exacerbate Roberts condition.…
The researchers found no significant mortality benefit of administering antibiotics within 3 hours of ED triage or 1 hour of shock recognition for patients with severe sepsis and septic shock (6). A 2015 ….. (level…evidence) similarly found that mortality amongst septic shock patients did not increase with hourly delays in administration of empiric antimicrobials (9). These incongruous results call into question the strength of the association between hourly delays in antimicrobial treatment and mortality in septic shock patients. However, these studies do not differentiate between gram (+) and gram (-) sepsis and their differing virulence factors.…
The pathophysiology of pneumonia can differ from patient to patient, can be external or internal, and different bacteria can take part in…