An 80-year-old female with a diagnosis of pneumonia was admitted to the hospital 2 days ago from a nursing home.The patient is responsive only to painful stimuli.She has a peripheral IV and a feeding tube in place.Physical examination reveals: pulse 98 bpm,respiratory rate 24 and shallow,blood pressure 100/48,and temperature 39.2° C.Auscultation reveals decreased breath sounds with crackles in the bases.The patient has an occasional weak,nonproductive cough.Arterial blood gas on NC 4 L/min is pH 7.42,partial pressure of carbon dioxide (P_aCO₂)38 mmHg,partial pressure of oxygen (P_aO₂)40 mm Hg,arterial oxygen saturation (S_aO₂)76%,bicarbonate (HCO₃^-)24 mEq/L.A portable chest x-ray shows patchy basilar infiltrates in both lungs.The most appropriate action to take at this time is which of the following?

Question

Quizplus · Accepted Answer

According to the arterial blood gas (ABG)this patient has a normal acid-base balance,therefore intubation and artificial ventilation are not necessary.The patient does not seem to have evidence of requiring a bronchodilator and mucolytic.The patient does not require noninvasive positive airway pressure ventilation (NPPV),because he is breathing.The patient does,however,have severe hypoxemia that warrants a high oxygen concentration.

An 80-Year-Old Female with a Diagnosis of Pneumonia Was Admitted