The finding indicates respiratory acidosis. Further, Rowena’s body is trying to compensate by increasing PaO2. These changes in ABG can also change the affinity of haemoglobin for oxygen.
Fig 1: Medbulets team (2018)
Rowena’s ABG results demonstrates right shift on oxygen haemoglobin dissociation curve, which can be identified by increased PCO2 and temperature and decreased pH of the blood. The right shift indicates that Rowena has decreased affinity in haemoglobin for oxygen. So, the O2 is released in tissue or cells easily. However, the body is trying to compensate the respiratory acidosis with the rise of PaO2. After the O2 is absorbed by the blood, the CO2 binds to the Hb to be excreted
from the body but in the case of Rowena, CO2 is not able to execrate by lungs due to disease condition so it is accumulating in the body which made the blood acidic. So, she is experiencing the sign of hyperventilation, such as shortness of breath and fatigue (Medbulets team, 2018) Evidence shows that hypercapnia impairs cell junction formation by promoting its physphorylaton, and degradation of alveolar epithelium and inhibits Na, K-ATPase beta subunit function. When these functions are impaired due to hypercapnia it effects alveolar fluid clearance (Kryvenko, Gabrielli, Dada, Seeger, Sznajder & Vadász, 2016). Pathophysiology COPD is a condition which causes irreversible damage to airways and lung parenchyma. The primary cause is tobacco smoke and air pollution, which leads to inflammation of the airway epithelium. That stimulates the release of cytokines and infiltration of inflammatory cells. Continuous bronchial irritation and inflammation causes bronchial oedema, hypersecretion of mucus and bacterial colonisation (chronic bronchitis). At the same time, it also causes breakdown of elastic tissue of the lungs leading to emphysema, which is a state of destruction of alveolar septa and loss of elastic recoil of bronchial walls. Chronic bronchitis and emphysema can result in air trapping, airway obstruction, loss of surface area for gas exchange and frequent infections. This is evidenced by cough, dyspnoea, hypercapnia and hypoxemia. If it is not managed on time, COPD leads to immediate risk of respiratory distress on patient (Craft, Gordon, Huether, McCance, & Brashers, 2015). Similarly, Rowena is also diagnosed for Pneumonia which is infection on lower respiratory tract. The most common route of this infection is aspiration of oropharyngeal secretions; thus, oropharynx and nasopharynx are identified as the first line defence for the most infectious agents. Another route of infection can be inhalation of microorganism through sneezes, cough, or talks. Finally, the bacteria may spread to the lungs if it passes the first line defence, then the alveolar macrophage acts as second line defence mechanisms. However, if the microorganisms are in large number, it can activate the body’s inflammatory and immune response. The body’s antigen- antibody reaction and endotoxins released by some organisms destroy bronchial and alveolar mucus membrane, causing inflammation with oedema and vascular congestion. Infectious exudates and debris can fill alveoli, affecting gas exchange and ventilation. Pneumonia can be developed in four different types, they are lobar pneumonia, bronchopneumonia, military pneumonia and interstitial pneumonia (Ignatavicius, & Workman, 2015).
The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow.
How much responsibility should any child have over their family? In "Bone," by Fae Myenne Ng, a character named Leila is born the daughter of a loving mother, Mah, and a run-out-on-the-family father whom cursed Leila with a last name Fu. As Leila said herself, "Fu in our dialect sounds like the word for bitter" (18). She became the oldest with two other sisters, Ona and Nina, whom both came from Mah's second husband, Leon. Leon loves his biological daughters like a true father should; meanwhile, Leon also loves Leila, his daughter only by marriage to Mah. Leon expresses how much he loves his daughters by saying "Five sons don't make one good daughter" (3), causing a scene in front of people who think that he is unlucky for not being blessed with a single son.
Hemoglobin is composed of four subunits (beta/Alpha) containing a heme group which binds an iron and that iron binds to the oxygen. The blueness of the skin occurs when, rather than carrying oxygenated hemoglobin, our blood carries deoxygenated hemoglobin in increased amounts “>5 g/dL”. In this case, the baby is experiencing central cyanosis, which is abnormal and needs to be treated immediately. When the doctor attempted to give the baby oxygen via nasal cannula, it did not change the blood oxygen saturation because although the concentration of blood oxygen levels increased, there is too much deoxyhemoglobin to cause the blood oxygen saturation percent to increase back to its normal state. Cyanosis occurs either because of decrease of oxygen in the blood, or due to a congenital heart defect known
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
The circulatory system and respiratory system share a highly important relationship that is crucial to maintaining the life of an organism. In order for bodily processes to be performed, energy to be created, and homeostasis to be maintained, the exchange of oxygen from the external environment to the intracellular environment is performed by the relationship of these two systems. Starting at the heart, deoxygenated/carbon-dioxide (CO2)-rich blood is moved in through the superior and inferior vena cava into the right atrium, then into the right ventricle when the heart is relaxed. As the heart contracts, the deoxygenated blood is pumped through the pulmonary arteries to capillaries in the lungs. As the organism breathes and intakes oxygenated air, oxygen is exchanged with CO2 in the blood at the capillaries. As the organism breathes out, it expels the CO2 into the external environment. For the blood in the capillaries, it is then moved into pulmonary veins and make
In this activity Respiratory Responses to Metabolic Acidosis and Metabolic Alkalosis is recorded. As the metabolic rate increases, BPM increases, Blood pH decreases, carbon dioxide increases, hydrogen ion increases and bicarbonate level decreases. Likely as the metabolic rate decreases, BPM decreases, Blood pH increases, Pco2 decreases, Hydrogen ion decreases, and bicarbonate level decreases. The respiratory system compensates for metabolic
Korina Cesteni’s article “King’s Coming of Age Tale”, describes that kids mature through many different ways according to their circumstances. Cesteni’s article focuses on Stephen King’s Different Seasons, The Body. Kids mature and begin to realize they are no longer children when they are put through various situations. They also mature through dealing with experiences including death, pain, injustice, and abuse.” Cesteni explains that Stephen King’s novella “The Body” is a,” bittersweet coming of age story.” In the novella, “The Body”, there are four main characters: Gordie, Chris, Teddy, and Vern. They are twelve year old boys who venture out to find the body of Ray Brower. During this journey, they realize that, “They are no longer children.”
At approximately 1724 hours on February 1, 2016, I, Cpl. Lessane, along with Deputy Eubanks, responded to 701 Boles Road, in the Cummings area of Hampton County, to meet with Florena Johnson, regarding an incident that occurred on a School bus with her daughter. During the disturbance on the School bus, a juvenile was threatened and felt fearful for her safety by three other subjects. Juvenile was told by the subjects, they were on the way to her residence; threatening to cause bodily injuries. The juvenile mother notified Law Enforcement and filed a Police report. No suspect (s) were on scene or in the area upon the arrival of deputies. The complainant was advised to call 911 if the subject (s) arrive at the residence at a later
Cyanotic heart disease is a heart defect, present at birth that results in low blood oxygen levels. With a series of surgeries, this condition is usually tr...
As CO Casteel performed CPR on MOODY, CO Dodson arrived back in the cell with a pulse oximetry meter and placed it on MOODY’S right index finger. According to CO Casteel, the pulse oximetry meter reading indicated MOODY’S peripheral oxygen saturation was at 72 percent. After noting MOODY’S peripheral oxygen saturation, CO Casteel resumed CPR on MOODY as Regional Paramedical Service (RPS) personnel entered the cell and joined his efforts to revive
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
The postabsorptive state is the period when the GI tract is empty and energy comes from the breakdpwn of our body’s reserves. The importance of the postabsorptive state is to maintain blood glucose levels. The brain fuels itself using glucose as its energy source. We can get glucose from stored glycogen, tissue proteins, and some from fats. The first available store of glucose is in the liver’s stores of glycogen. These stores can maintain blood sugar levels for around four hours. When the liver stores begin to get small, glycogenolysis begins to take place in skeletal muscles. The glucose in the skeletal muscles is converted to pyruvic acid, which enters the blood and is converted back to glucose by the liver and again reenters the blood.
Hemoglobin functions as transporter of oxygen molecular. The hemoglobin picks up O2 from the pulmonary system and delevers it to the body cells. oxyhemoglobin is a hemoglobin louded with O2 and deoxyhemoglobin is not louded with O2 . Blood in arteries is brighter red than the blood in veins. Hemoglobin molecule has four units of globin in addition to four units of heme. Estimation of serum Hb is a test that measures the level of free Hb in the liquid part of the blood (the serum). This test is done to diagnose or monitor the severity of a low RBC count caused by the abnormal breakdown of RBCs). Standard blood tests can also be performed on the blood that extracted from the arteries, like determining glucose level, hemoglobins and dys-haemoglobins, and electrolytes. The abnormal result indicate: -Drug-induced immune hemolytic anemia-G6PD deficiency-Hemoglobin C disease-Hereditary spherocytosis-Idiopathic autoimmune hemolytic anemia-Paroxysmal cold hemoglobinuria (PCH)-Paroxysmal nocturnal hemoglobinuria (PNH)-Sickle cell anemia-Thalassemia. An arterial blood gas (ABG) is a bloo...
Alveolar hyperventilation causes a decreased partial pressure of arterial carbon dioxide (PaCO2). The decrease in PaCO2 increases the ratio of bicarbonate concentration to PaCO2 which increases the pH level. The decrease in PaCO2 develops when a strong respiratory stimulus causes the respiratory system to remove more carbon dioxide than is produced. Respiratory alkalosis can be acute or chronic. Acute respiratory alkalosis is when the PaCO2 level is below the lower limit of normal and the serum pH is alkalemic. Chronic respiratory alkalosis is when the PaCO2 level is below the lower limit of normal, but the pH level is relatively normal or near normal. Respiratory alkalosis is the most common acid-base abnormality observed in patients who are critically ill. It is associated with numerous illnesses and is a common finding in patients on mechanical ventilation. Many cardiac and pulmonary disorders can occur with respiratory alkalosis. When respiratory alkalosis is present, the cause may be a minor or non–life-threatening disorder. However, more serious disease processes should also be considered in the differential diagnosis (Byrd, 2017). Hyperventilation is most likely the underlying cause of respiratory alkalosis. Hyperventilation is also known as over breathing (O’Connell, 2017).
In the essay “Beauty (Re)discovers the Male Body,” author and philosopher Susan Bordo discusses the history and current state of male representation in advertisements. While using her feminist background, Bordo compares and contrasts the aspects of how men and women are portrayed in the public eye. She claims that there has been a paradigm shift the media with the theory that not just women are being objectified in the public eye, but also men too. Since the mid-1970s, with the introduction of Calvin Klein commercials, men have started to become more dehumanized and regarded as sex symbols. In a similar fashion to how Bordo describes gender, race plays a similar role in the media. People of all different ethnicities and cultures are being categorized into an oversimplified and usually unfair image by the media over basic characteristics.