A 55-year-old male with acute dyspnea is admitted to the hospital. He is alert and oriented. His physical examination reveals: heart rate 120 beats/min and regular; blood pressure 146/88 mm Hg; temperature 38° C; respiratory rate 28 breaths/min shallow and labored. Breath sounds are decreased throughout with fine late crackles on inspiration, chest expansion is decreased in both bases. The patient is not coughing. The ABG on room air is: pH 7.52; PaCO₂ 30 mm Hg; PaO₂ 42 mm Hg; Hb-O₂ 80%; HCO₃^- 24 mEq/L. This patient is retired after working in a steel factory for 38 years and he has a 50-pack-year history of smoking. The most appropriate action for the respiratory therapist to take is which of the following?

Question

Quizplus · Accepted Answer

According to the arterial blood gas (ABG)this patient is able to move air as evidenced by a partial pressure of carbon dioxide (PₐCO₂)of 30 mm Hg (respiratory alkalosis); therefore intubation and artificial ventilation are not necessary.The patient does not require noninvasive positive pressure ventilation (NPPV),because he is breathing.The patient does not seem to have evidence of requiring a bronchodilator and a mucolytic.The patient does,however,have moderate hypoxemia.Since the patient is not a carbon dioxide (CO₂)retainer,a high concentration of oxygen may be applied in the form of high flow nasal cannula.

A 55-Year-Old Male with Acute Dyspnea Is Admitted to the Hospital