Acute is a condition in which carbon dioxide builds up very fast, before the kidneys can return the body to homeostasis. Symptoms of respiratory acidosis may include: Sleepiness, easy fatigue, confusion, and shortness of breath and lethargy. Treatment is aimed to the underlying disease, oxygen if the blood level is low, treatment to stop smoking, Noninvasive positive-pressure ventilation (called CPAP) or a breathing machine and some Bronchodilator drugs to reserve airway obstruction. Compensation refers to the body 's natural mechanisms of counteracting a primary acid-base disorder in an attempt to maintain homeostasis. In Respiratory Acidosis, the elevation in PCO2 result from a reduction in alveolar ventilation.
Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.
2012). An anticholinergic nebulizer, ipratropium was given to mrs.Smith as per the order which helped to reduce dyspnea and cough slightly. Her Early warning score still remains 6. On detailed examination, Ed doctor suspected mrs.Smith may be having heart failure. ECG done on her which shows sinus tachycardia.
Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.
While auscultating sounds of lung fields no wheezing was found, and VS were within normal range for patient as determined through comparison of chartings on 10/23/2015 thru the morning and lunch VS of 10/26/ 2015 before impaired gas exchange was detected. 10/26/2015 2. Administer O2 @ 2L N/C
The anaesthetist removed the ETT and proceeded to place a tight fitted mask on patients face. (REF)She then alerted the team that there was a problem with the patient airway (REF). The mask did not mist up – indicating of no air movement return, there was no carbon dioxide trace on the capnography and the patient oxygen saturation dropped steadily from 100% to 90%. He instigated vigorous jaw thrust to improve oxygenation, and using continuous positive airway pressure(CPAP) to deliver 100% oxygen flow through the breathing bag attached to the anaesthetic machine but all this effort was not having any effect on the ventilation. He then asked my mentor the Operating Department Practitioner (ODP) to administer 50mg/5ml of intravenous Propofol.
Uses a walker. • Mr. Raj Singh, a 68-year-old admitted with chest pain and scheduled to have a cardiac catheterization done today at noon. He is very anxious and rings the call bell every 15 minutes to ask whether he is going to die and if the cardiac catheterization is really necessary. • Mr. George Rivera, a 38-year-old Mexican male, admitted with high blood sugars and newly diagnosed with diabetes.
Mildred was transferred to Hebrew Rehabilitation Center, less than 72 hours post op, which for a risky patient is unfathomable to me. When I visited her the same afternoon she felt as though she’d “been given the bum’s rush”, meaning there was a sense of urgency at NEBH to have an x-ray, and bowel movement requiring an enema or suppository before she left. The continued low blood pressure, worried her. Furthermore, she felt uneasy about the surgical blood loss requiring RBC transfusions.
• No interventions for post sedation were implemented for oxygen and vital signs below the normal limits. • During conscious sedation respiratory therapy should have been notified and standing by, as well as evaluating the patient post sedation. They should have been notified of the low oxygen levels. • The LPN and the nurse did not notify the MD that the patient’s vital signs and oxygen were low. • The LPN reset alarms without notifying the nurse or the MD.
The exudative phase unfolds over the first 1 to 7 days after attack of lung injury. Accumulation in the alveoli of excessive fluid, protein and inflammatory cells that have move into the air spaces from the alveolar capillaries. Intrapulmonary shunt develop and blood passing cannot be oxygenated. Alveolar type I and type II cells are spoiled causing surfactant dysfunction. Alveoli become unstable and collapse and fibrotic changes take place.
The patient’s respiratory pattern is that of Kussmaul breathing. This is the body’s attempt to blow off as much carbon dioxide to compensate for the metabolic acidosis from DKA, seen when the pH is less then 7.20 (McCance & Huether, 2014). The patient will have a fruity odor on his breath due to the keto acid.
Her medical diagnosis of ARDS from overdosing and pneumonia are the cause of her deteriorating condition. Then, it moves on to the first two primary nursing diagnoses of impaired gas exchange and risk for infection, followed by the lower ranked ones of impaired tissue integrity, anxiety, and finally decrease cardiac output. The case study then explored her expected outcomes, the interventions used for her primary two nursing diagnoses with literature reviews, and finally an evaluation of the plan of care. The learning from this patient is that it is not our place as nurses and medical personnel to judge, but to treat with fairness and compassion. It is easy to look down on this patient for her chronic illnesses that affect her long-term health, but she needs help, and now may never be back to her pre-hospitalized state.