Please explain as much as you can! Thank you so much A 59 year old carpenter cam
ID: 59452 • Letter: P
Question
Please explain as much as you can! Thank you so much
A 59 year old carpenter came into the emergency room complaining of shortness of breath. His pulse was 112/min and his blood pressure 138/88mmHg. His respiratory rate was 35/min, and his breathing was extremely labored. Loud breath sounds with some crackling were heard over all lung fields. The patient had an ashen complexion and his nail beds were cyanotic. An arterial blood sample was drawn and sent to the lab for blood gas analysis. A chest X-ray was ordered and the patient was given oxygen to breathe.
Given the information you have about the patient, predict the deviations from normal (increase, decrease, no change) you would expect him to have in the following parameters before he was given oxygen.
PaO2 (mmHg)__________________________
PaCO2 (mmHg) ________________________
pHa __________________________________
30 minutes later, the patient was found to be unresponsive. His complexion had changed to a flushed pink with no trace of cyanosis. His respiratory rate was 9/min and his breathing was quiet. His heart rate was 140/min and his blood pressure was 85/50mmHg. The patient was in a deep coma.
Compared with the time the patient came into the ER, predict the changes in the values of the parameters below (increase, decrease, no change) when he became comatose. Explain your predictions.
PaO2 (mmHg)__________________________
PaCO2 (mmHg) ________________________
pHa __________________________________
When the patient was first admitted, his respiratory rate was 35/min. When he was comatose, his respiratory rate dropped to 9/min. What caused the change? Explain the sequence of events that caused him to become comatose.
Explanation / Answer
The symptoms presented by the patient are exclusive for a case of hyperventilation with brainstem injury. In such cases, the levels of PaO2 are elevated, PaCO2 are lowered and there is an elevated level of arterial pH (pHa). These are the common test results in such cases.
Since the patient did not respond to the Oxygen, the patient suffers from hypoxia. When the patient is in comatose stage, there is no oxygen supply to the brain, PaO2 levels decrease to < 25 (mmHg), the PaCO2 levels increase above normal levels, the arterial pH also lowers considerably.