S. METABOLIC ACIDOSIS T. METABOLIC ALKALOSIS A. CHRONIC BRONCHITIS B. EMPHYSEMA C. PULMONARY EMBOLUS D.

S. METABOLIC ACIDOSIS T. METABOLIC ALKALOSIS A. CHRONIC BRONCHITIS B. EMPHYSEMA C. PULMONARY EMBOLUS D. PULMONARY EDEMA E. TUBERCULOSIS F. THIN: SKIN PINK G. OXYGENATED H. FROM BLOWING OFF CO2 I. LUNGS FILLED WITH MUCUS J. DIFFICULTY WITH EXPIRATION K. SKIN BLUE-ISH & PUFFY L. RR 26/MIN; RETRACTIONS PRESENT M. RR 18/MIN; STRIDOR HEARD N. RESPIRATORY ALKALOSIS o. DIFFICULTY WITH INSPIRATION P. RESPIRATORY ACIDOSIS Q. DIFFICULTY BREATHING THROUGH FLUID-FILLED ALVEOLI R. STIFF LUNGS WITH BLEBS Eor questions 13-19, choose one of A-T from box above to answer questions about the scenario below. Don’t re-use a letter. Choose BEST FIT from the choices (a-d) you are given. Ihe scenario: A 50 year old male is evaluated in the emergency room (ER) for a complaint of dyspnea. The dyspnea has become worse over many years but today is especially bad. He reports a history of smoking. His breath sounds are clear but greatly diminished throughout his lungs. ABGS, peak flow test (PF), VQ scan and chest x-ray (CXR) are completed. Results are below. ABGS: pH Z48, PCO2: 30, HCO3: 24, PO2 80, S02 94%. PF: 50 % of predicted norm (ie, “low PF). V/Q scan Q.8 CXR shows hyperinflated aveoli and air trapping. (Remember, you are supposed to know pH range, SO2 range, & RR range) Normal ABG ranges: PO2: 80-100 mmHg PCO2: 35-45 mmHg HCO3: 22-26 mEq/L Putting together all information given, what is the most likely diagnosis on this patient? 13. D a. b. B C c. d. A Using the “patient picture” scenario & correct answer from # 13, what is the expected breathing rate & pattern of this patient? 14 L a b. M C. d. What do you expect his general appearance to be like? 15. a. b. C. K d. The low PF in this scenario indicates 16. Q a. b M C C. d. o d 17 What acid base imbalance does this patient have? a. b. T N C. d. P 18. The acid/base imbalance above is part of a compensatory response to keep the body F a. b. G H C. d. K If you could look at this patient’s lungs directly, you would expect to 19. see D a. b. E C. d.

 
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