Mr. Jones is a 78-year-old gentleman who presents to the clinic with a chief grievance of fever, chills and cough. He additionally studies some dyspnea. He has a historical past of proper sided CVA, COPD, dyslipidemia, and HTN. Present medicines embrace atorvastatin 40 mg po qhs, lisinopril, and fluticasone/salmeterol. He studies extra use of his albuterol rescue inhaler. Very important indicators Temp 101.eight F, pulse 108, respirations 21. PaO2 on room air 86% and on O2 four L nasal canula 94%. CMP WNL, WBC 18.four. Bodily reveals skinny, anxious gentleman with gentle hemiparesis on left aspect due to CVA. HEENT WNL aside from diminished gag reflex and uneven elevation of the uvula, CV-HR 108 RRR with out murmurs, rubs, or click on, no bruits. Resp-coarse rhonchi all through lung fields. CXR reveals consolidation in proper decrease lobe. He was identified with group acquired pneumonia (CAP).
Question Assignment: Affected person was hypoxic as evidenced by the low PaO2. Clarify the pathologic processes that brought about this affected person’s hypoxemia.
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Mr. Jones, a 78-year-old gentleman, comes to the clinic with a fever, chills, and cough as his main grievance. He additionally complains of breathlessness. He has a right-sided CVA, COPD, dyslipidemia, and HTN historical past. Atorvastatin 40 mg po qhs, lisinopril, and fluticasone/salmeterol are amongst the present medicine. He says he is been utilizing his albuterol rescue inhaler a lot extra currently. Indicators of life Temp 101.eight F, pulse 108, respirations 21. PaO2 on room air 86% and on O2 four L nasal canula 94%. WBC 18.four, CMP WNL Bodily reveals skinny, anxious gentleman with gentle hemiparesis on left aspect due to CVA. HEENT WNL aside from diminished gag reflex and uneven elevation of the uvula, CV-HR 108 RRR with out murmurs, rubs, or click on, no bruits. Resp-coarse rhonchi all through lung fields
