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- At 11 p.m., a patient is admitted to the Emergency Department (ED) with a respiratory rate of 44 breaths/minute and SaO2 85%. They are anxious with audible wheezes. The patient is immediately given nebulised Salbutamol follow by oxygen via face mask and Hydrocortisone intravenously (I.V). 1. Explain the reason for Intravenous (I.V) Hydrocortisone56. A 70-year-old man is brought to the emergency department because of severe shortness of breath for 4 hours. He has had fatigue for 6 months and moderate shortness of breath for 2 weeks. On arrival, he is pale and diaphoretic and is seated straight upright on the stretcher. His respirations are 30/min, and blood pressure is 110/90 mm Hg. Inspiratory moist crackles are heard over the posterior lower half of the lung fields. There is mild pedal edema. An increase in which of the following is the most likely cause of this patient's dyspnea? ↑P₂ OA) Capillary diffusion coefficient B) Capillary hydrostatic pressure OC) Capillary oncotic pressure D) Interstitial hydrostatic pressure E) Interstitial oncotic pressureA event At 11 p.m., a patient is admitted to the Emergency Department (ED) with a respiratory rate of 44 breaths/minute and SaO2 85%. They are anxious with audible wheezes. The patient is immediately given nebulised Salbutamol follow by oxygen via face mask and Hydrocortisone intravenously (I.V). 1. Explain the reason for Intravenous (I.V) Hydrocortisone.
- 2. Jean Claude has asthma, and his health care team has decided to add fluticasone (Flovent) 220 mcg twice a day in the orally inhaled form.a. How does fluticasone improve asthma symptoms?What are the most important points that Jean Claude needs to understand about taking this new medication?4.3. Calculate the carbon dioxide volume expired during one hour by person performing the physical activity under calm conditions.187. A previously healthy 59-year-old man comes to the emergency department because of a 1-day history of fever, shortness of breath, and productive cough. He appears to be in moderate distress. His temperature is 38.4°C (101.1°F), and respirations are 26/min. Pulse oximetry on room air shows an oxygen saturation of 88%. Bronchial breath sounds are heard over the right lung base posteriorly with egophony and increased tactile fremitus. A chest x-ray shows right lower lobe pneumonia. Which of the following mechanisms is the most likely cause of the hypoxia in this patient? A) Alveolar fibrosis B) Hypoventilation C) Right-to-left cardiac shunt D) Right ventricular failure E) Ventilation-perfusion mismatch 27
- 2. 3. The doctor has ordered 60mg furosemide PO 12-hourly for Mrs. A. The furosemide tablets are labelled 20mg. How many tablets does Mrs. A receive in a day? Prozac stock is labelled 20mg/5mL. Mr. B is prescribed 40mg Prozac. How many mL will you give?Table 1: Arterial blood gas concentration in patient Two hours after aspirin ingestion Ten hours after aspirin ingestion Normal values Partial Pressure CO2 26 mm Hg 19 mm Hg 35-45 mm Hg Partial Pressure O2 113 mm Hg 143 mm Hg 75-100 mm Hg Bicarbonate [HCO;] 18 mM 21 mM 22-26 mM pH 7.44 7.55 7.35-7.45 Blood salicylate concentration, mg/dL 57 1171. What is the disorder of this 17-year-old student? Why? 2. Is this primarily a restrictive or an obstructive disorder? Why? 3. Write the formula for determining residual volume (RV). 4. Determine the residual volume (RV) before and after the use of the bronchodilator. a. RV before using the bronchodilator: b. RV after using the bronchodilator: 5. Why is expiration more difficult than inspiration in this person? 6. What does the change in pulmonary function after the bronchodilator therapy indicate? 7. Why does the bronchodilator exaggerate the tachycardia? 8. What causes the hypoxemia and the hypocapnia in this person? 9. A beta 2-adrenergic agent was prescribed for further use because it has less cardiostimulatory (beta1) effect. Based on your knowledge of beta1 and beta2 receptors, why is this a good suggestion? 10. An anticholinergic agent was also suggested as a possible nebulizer agent. How might this help the breathing problem?
- There is a theory that suggests a patient with COPD might have a depression of ventilation following administration of high fiO2. Which of the following best summarizes the recommendations on how to address this concern? A. Never administer supplemental oxygen to patients with COPD as the risk of them stopping breathing is too great B. Treat acute hypoxemia with oxygen, but wean the oxygen as soon as possible C. Always double filter oxygen being delivered to a patient with COPD to ensure there are no particles that may be breathed in D. Supplement oxygen therapy with medical grade carbon dioxide to maintain dr to breathe8. Which of thr following occur(s) during hypoxemia? A. Increased ventilation B. Increased production of 2.3-DPG C. Increased production of erythropoietin D. All of the choices 1. Explain why a person with ketoacidosis may hyperventilate. What benefit might this provide? 2. Using a flowchart, explain how a rise in blood PCO2 stimulates breathing. Include both the central and peripheral chemoreceptors in your answer.61. Given that atmospheric pressure is 760 mmHg, lung pressure should be ______ mmHg for air to move out of the lungs. 760 mmHg 758 mmHg 763 mmHg none of these choices