Mrs. Fiona Marta is a 71-year-old retired nurse who served in Vietnam. She is admitted with a diagnosis of COPD, acute respiratory distress and relates a 50-year history of smoking two packs of cigarettes per day. During the past week, Mrs. Marta states she has had flu-like symptoms such as fever, chills, productive cough with thick, brown purulent sputum, and chest pain when coughing. Mrs. Fiona appears to be anxious and irritable, taking rapid, shallow breaths while breathing through her mouth. She is also diaphoretic and has marked cyanosis around her lips. Auscultation reveals moist crackles throughout both left and right lung fields. Vital signs are 38.3C, P 114, RR 28, and BP 120/70 O2 Sats 88%. Question 1: At this point, what are four important things to include in your assessment? (4) A chest X-ray shows lung infiltrates, and a sputum specimen contained numerous gram-positive diplococci. Baseline arterial blood gases on a 50% nonrebreather mask are pH 7.30; pC02 60; Pa02 50; and HC03 18. Question 2: Is the current oxygen delivery system appropriate for Mrs. Marta and why or why not? (2) Question 3: What general information can be obtained from the chest X-ray and what do the results indicate? (2)
[Expert Solution]: Mrs
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