Exercises: (10 Points Each) How

Exercises: (10 Points Each) How are alveolar ventilation and oxygenation estimated and assessed? Alveolar ventilation is equal to the tidal volume minus dead space times the breaths per minute. Ventilation as compared to perfusion is measured to ensure proper levels. Alveolar oxygenation can be using a non-invasive helium washout technique. Both of these are used to assess the levels in the body of a patient to ensure the body is functioning properly (McCance & Huether, 2010).

What pathophysiologic factors might alter ventilation-perfusion matching in the lungs? The ratio of air reaching the alveoli to the amount of blood reaching the alveoli is measured. The oxygen should be just enough saturate the blood but if it's not at that level, it causes problems. Disorders and problems that can cause issues include bronchitis, asthma, pulmonary edema and pulmonary embolism (McCance & Huether, 2010).

What are the clinical manifestations and common causes of acute airway obstruction? Symptoms of acute airway obstructions include agitation, fidgeting, choking, confusion, problems breathing, panic and alterations to consciousness. Causes include croup, trauma, vocal chord issues, viral or bacterial infections, and allergic reactions (McCance & Huether, 2010). 4.

What is the rationale for using drugs such as ?2 agonists, acetylcholine antagonists, corticosteroids, and mast cell stabilizers to manage obstructive pulmonary disorders? Their main purposes is to unconstrict the passages in the lungs thus making breathing easier as this is the main problem with obstructive pulmonary disorders. Inflammation that is causing the problems is also reduced. The drugs can either be short-acting or long-acting based on how quick the onset of symptoms is and how long the symptoms last (McCance & Huether, 2010). 5.

What pulmonary function test abnormalities are characteristic of obstructive and restrictive pulmonary disorders? In restrictive lung disease, the FEV1 and FVC test results are reduced whereas the FEV1 is reduced while FVC remains stable (McCance & Huether, 2010). Professional Development (20 points each) From the Brashers textbook, please complete the following case studies: 1. Chapter 5: Asthma Question 1 The confluence of the rhinorrhea, dyspnea, and chest pain is indicative of an asthma attack or something similar in nature. This was almost certainly brought on by pollen kicked into the air by the mower (Brasher, 2012).

Question 2 The patient should be asked whether any similar attacks have happened before. It should be asked if the same thing happened the last time the teen mowed the lawn and, if so, how recently that occurred. The teen should be asked if she has a known allergy to pollens, whether she has asthma, and whether she's been prescribed an inhaler in the past (Brasher, 2012). Question 3 She seems to have a protracted and advanced history of asthma and/or other breathing issues.

The blue inhaler indicates she has sudden and nasty attacks. The allergy to grass confirms the ostensible cause of this most recent attack. The fact that she uses the inhaler up to twice a day is fairly alarming (Brasher, 2012). Question 4 A full battery of pulmonary tests to measure blood gases, oxygen in particular, needs to be measured. An ECG is a good idea (Brasher, 2012). Question 5 The inflammation and constriction of the airways needs to be treated immediately.

Also probably a good idea to start introducing oxygen into the bloodstream as this is possibly too low but need to wait for better results as too much oxygen can be toxic (Brasher, 2012). Question 6 Her a -- a gradient is the oximetry reading at the top of the lab results and it is dangerously low. Anything below 91 is a bad number per the chapter notes. Question 7 PAC02 is technically within the normal range but it is on the high side of it.

The same is true of the Ph…technically in the area of normal but also high. It is probably trending upwards and that is the issue. Her symptoms overall are becoming worse and that is leading to her cold touch and confusion (Brasher, 2012). Question 8 Blood oxygenation needs to occur immediately (Brasher, 2012). Question 9 Patient is better now, obviously, but had a rather close call. She needs to be careful and expect to avoid situations where this could happen again (Brasher, 2012).

Question 10 A corticosteroid or antagonist should be prescribed to address acute and sudden attacks. She should take drugs for rapid onset of symptoms only when called for but drugs that keep her level as time goes on should be taken consistently (Brasher, 2012). Question 11 The girl needs to not mow the lawn anymore or otherwise expose herself to situations that can lead to attacks (Brasher, 2012). 2.

Chapter 6: COPD Question 1 The patient should be asked if she is currently smoking, is around someone that is smoking or has a closely-related person (a parent in particular) that does. The patient should be asked if she or anyone in her family has a history of heart issues (due to the ankle swelling combined with the shortness of breath). Should be asked if there have been any notable changes in weight in either direction and whether there is any sputum or other symptoms (Brasher, 2012).

Question 2 The patient should be asked how long she smoked and whether anyone smoked in her presence, especially family. Ask her if smoking improved her condition or if it made no difference (or got worse). The variation and quantity of the sputum should also be asked about. Whether there was any blood or other coloration would be relevant.

Would also be a good idea to question whether occupational exposure occurred and the family history of pulmonary issues (heart issues were already addressed) Question 3 The patient could have a pulmonary disorder like COPD but it could also be heart-related. Both should be checked out thoroughly as both could be quite deadly. At this point, it seems to be a pulmonary issue (Brasher, 2012). Question 4 The yellowed teeth are not a good sign.

If the patient quit smoking five years ago, it is odd for her to still have yellowed teeth unless she's made no attempt to clean up the teeth after she stopped. The barrel chest is also a negative. Her pursing of her lips when she breathes is not a good sign and neither is the distention. Her dyspnea when climbing the table was also a bad sign. The dyspnea along with the accessory muscle use would indicate COPD or something along those lines.

Having a shortness of breath when just climbing a table is a sign of strong lack of breathing function, whatever the reason for it may be. Plus signs include the fact that she has no cyanosis or clubbing and that she's alert. She has no rashes or masses and her strength seems to be good overall (Brasher, 2012). Question 5 Testing of the sputum contents should be done to confirm no presence.