Question

Helga Freidericks is a 57-year-old woman who came to the urgent-care clinic today complaining of SOB. On admission, her respiration's were labored, at a rate of 32 breaths per minute. Her SpO₂ was just 84%, and her VC was decreased. She appeared anxious and stated that she:[couldn't] get enough air". Her lungs had bilateral wheezes throughout, scattered rhonchi, and bilateral crackles. She had a frequent cough, productive of thick green sputum.

Stat ABGs were drawn. She was put on O₂ at 2 liters per minute (lpm) per nasal cannula (NC) and given a nebulizer Tx. A sputum specimen was collected and sent for culture and sensitivity (C&S). She was given IV doses of a broad-spectrum antibiotic and a steroid drug. Upon review of her ABGs, it was determined that she was in a state of mild respiratory acidosis.

A short time later, Mrs. Freidericks's respiratory rate had decreased to 20 breaths per minute, her O₂ saturation was 91%, and she stated that she was breathing "much better." She was then transferred to the hospital for further monitoring and continued therapy.

5. Which of the following statements is true? (more than 1 answer may be correct)

a) Mrs. Freidericks normally slept lying down

b) It is always safe to give high levels of oxygen to people with COPD

c) Supplemental O2 effectively relieves dyspnea in the final stages of COPD

d) Mrs. Freidericks’s chest cavity had most likely become more barrel-like in shape

Answer 1

Here the patient is diagnosed to have COPD due to low sp02 and respiratory acidosis experienced. There are two choices which are found to be correct here. The first one is option "b" where a patient with COPD need to be given very high dose of oxygen as to sustain life. Secondly, patients with COPD in its advancing stage will have a barrel shaped chest. Therefore option"d" here also is the most likely correct answer. The first option is not possible as patient does not show any sign of GERD. Option "c" here also is not true as there is no practical evidence behind use of secondary oxygen in advanced stages of COPD. Therefore, to conclude, option "b" and "d" are the most likely answers here.