acute asthma

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acute asthma

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13 Posts

prasannakumar
Forum Senior

Topics: 24
Posts: 55

07/05/07 - 01:18 PM

A 24-year-old Caucasian man is brought to the emergency room with acute asthma exacerbation. His current medications include inhaled fluticasone and salmeterol. The attack started 10 hours ago and did not respond to numerous albuterol inhalations and systemic steroids. His blood pressure is 120/70 mmHg and heart rate is 110/min. The patient is tachypneic and speaks with difficulty. Lung auscultation reveals decreased breath sounds, prolonged expiration, and bilateral wheezing. Pulse oximetry showed 86% at room air. ABG at room air are: pH - 7.43, Po2 - 68 mmHg, Pco2 - 40mmHg. The chest x-ray demonstrates hyperinflated lungs. Which of the following findings indicates that the patient is getting worse?
A) Lung hyperinflation
B) Tachypnea
C) Tachycardia
D) Hypoxia
E) Normal Pco2

dr in trouble
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Topics: 62
Posts: 601

07/05/07 - 01:47 PM

Hypoxia????

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young_doc
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Topics: 56
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07/05/07 - 02:21 PM

normal PCO2?

Because with his tachypnea, i would expect him to be blowing off CO2. The fact that he's retaining it worries me.

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usmlestud
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Topics: 6
Posts: 68

07/05/07 - 02:22 PM

e..

elitoki
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Topics: 54
Posts: 508

07/05/07 - 02:45 PM

E.- Normal pCO2. nod

Ivonne
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Topics: 57
Posts: 1,651

07/05/07 - 02:46 PM

E. Normal PCo2. I agree with young_doc.

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khorshid
Forum Guru

Topics: 32
Posts: 591

07/05/07 - 03:04 PM

E for sure nod

surgeon99
Forum Senior

Topics: 9
Posts: 98

07/05/07 - 03:47 PM

normal or decrease in PaCo2

ssrpk
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Topics: 154
Posts: 2,819

07/05/07 - 03:51 PM

surgeon99 wrote:
normal or decrease in PaCo2

normal or increase

what other factors are worrisome?

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neo335
Forum Elite

Topics: 39
Posts: 174

07/05/07 - 09:45 PM

#10

normal reaching PCO2 and the acidosis (pH) is worrisome.. if no intervension is done right now then the pt will have further rise in his PCO2 n decrease in pH... yes his PCO2 has been increasing from the previously low levels.. n hav now reached the normal level.. n if this continues , it will reach still higher...

crazyserb
Forum Newbie

Topics: 4
Posts: 41

07/08/07 - 04:36 PM

#11

e) normal PCO2

In acute asthma, the compensatory mechanism is hyperventilation, so initially, the PCO2 should be decreased, but if the condition lasts for long and respiratory muscles are in fatigue, the PCO2 goes back down, to normal...

cirus
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Topics: 108
Posts: 740

07/09/07 - 03:51 AM

#12

yep PCO2 for sure

doyoudig
Forum Guru

Topics: 144
Posts: 613

07/09/07 - 08:51 AM

#13

E) Normal Pco2 or increasing Pco2 !!!

Asthma attck usually starts off with low PaCO2 and as the attck gets worse Co2 levels normalize or begin to increase

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