Mr. Worried is a 52-year-old widow. He is retired and living alone. He enters th

Question

Mr. Worried is a 52-year-old widow. He is retired and living alone. He enters the ED complaining of shortness of breath and tingling in fingers. His breathing is shallow and rapid. He denies diabetes; blood sugar is normal. There are no EKG changes. He has no significant respiratory or cardiac history. He takes several antianxiety medications. He says he has had anxiety attacks before. While being worked up for chest pain an arterial blood gas (ABG) analysis is done. The ABG results are:

pH= 7.48

PCO2= 28

HCO3= 22

PO2= 85

Problem:

pH is _____________ (high or low)

PCO2 is _____________ (high or low)

He is in respiratory _____________ (alkalosis or acidosis)

Solution:

1- What breathing pattern is the patient exhibiting?

2- Mr. Worried is probably suffering from a(n) ___________________.

3- The simplest solution to treat his immediate respiratory issue (shortness of breath, rapid, shallow breathing) is to do what?

4- Why does the simple treatment listed in #3 above work? * Please note this will not work on a person with chronic CO2 retention, such as a COPD patient. These people develop a hypoxic drive, and do not respond to CO2 changes.

Explanation / Answer

Normal pH range is 7.35-7.4 ..so this quite normal( slightly high)

Partial presurre of co2 is 38-42mm hg therfore it is markedly decresed indicating he is in RESPIRATORY ALKALOSIS

Answer1= kussmaul breathing ( shallow and labored breathing) it is kind of hyperventilation leading to flushing out the co2 , therefore levels of co2 in blood decreses.

Answer2=hyperventiltion syndrome becuase of anxiety.

Answer3=to calm the patient and tell him to breath deep and SLOW.

AMSWEE4=main cause of this anxiety leading to hyperventilation in a patient and decresed co2 levels .therefore treating the underlying anxiety disorder is highly useful

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