R.S. has smoked for many years and has developed chronic bronchitis, a chronic o

Question

R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2 = 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia.

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2. Interpret RS’s laboratory results. How would his acid-base disorder be classified? What is the most likely cause of his polycythemia?

Explanation / Answer

Lab results- pH is 7.32.which is more alkalic.

Paco2 is increased hypercapnic

Po2 is decreased than normal hypoxic

Hco3 increased

Hematocrit value normal

He is suffering from Respiratory acidodis and metabolic acidosis.

Because of the lung failed to remove exceeds co2 and hypercapnia the body compensates by producing more cbc by a factor in kidney called hematopoiten in kidney. This is reason for polycythemia.

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