A patient is admitted with acute respiratory failure attributable ...

[DelorasTo]

A patient is admitted with acute respiratory failure attributable to pneumonia. Smoking history reveals that the patient smoked two packs of cigarettes a day for 25 years, stopping 10 years ago.
 
  ABG values on the current ventilator settings are pH, 7.37; PaCO2, 50 mm Hg; and HCO3-, 27 mEq/L. Chest radiograph reveals a large right pleural effusion. Intrapulmonary shunting value of 35 indicates
 
  a. normal gas exchange of venous blood.
  b. an abnormal finding indicative of a shunt-producing disorder.
  c. a serious and potentially life-threatening condition.
  d. metabolic alkalosis.

Question 2

A patient presents with the following values: pH, 7.20; paO2, 106 mm Hg; paCO2, 35 mm Hg; and HCO3-, 11 mEq/L. These values are most consistent with
 
  a. uncompensated respiratory acidosis.
  b. uncompensated metabolic acidosis.
  c. uncompensated metabolic alkalosis.
  d. uncompensated respiratory alkalosis.

[Dominic]

Answer to Question 1

C
A shunt greater than 10 is considered abnormal and indicative of a shunt-producing disorder. A shunt greater than 30 is a serious and potentially life-threatening condition that requires pulmonary intervention.

Answer to Question 2

B
The pH indicates acidosis, and the HCO3- is markedly decreased, indicating a metabolic disorder. Uncompensated metabolic acidosis values include a pH below 7.35, PACO2 of 35 to 45 mm Hg, and HCO3- above 22 mEq/L. Uncompensated respiratory acidosis values include a pH below 7.35, PACO2 above 45 mm Hg, and HCO3- of 22 to 26 mEq/L. Uncompensated respiratory alkalosis values include a pH above 7.45, PACO2 below 35 mm Hg, and HCO3- of 22 to 26 mEq/L. Uncompensated metabolic alkalosis values include a pH above 7.45, PACO2 of 35 to 45 mm Hg, and HCO3- above 26 mEq/L.

[DelorasTo]

TYSM

[okolip]

Gracias!