Respiratory Disease: A Case Study Approach to Patient Care by James R. Dexter MD FACP FCCP, Robert L. Wilkins PhD RRT

By James R. Dexter MD FACP FCCP, Robert L. Wilkins PhD RRT FAARC, Philip M. Gold MD FACP FCCP

Now edited through a pulmonologist, the third variation remains to be essentially the most well-written texts for college kids studying to appreciate the overview and remedy of sufferers with breathing illness. each one bankruptcy starts off with a historical past of chosen issues, via a case research with questions and solutions designed to stimulate serious pondering abilities.

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Extra resources for Respiratory Disease: A Case Study Approach to Patient Care

Sample text

Clinical findings that suggest ventilatory failure include headache, diminished alertness, warm and flushed skin, and bounding peripheral pulses. These findings are very nonspecific, as they occur in a variety of conditions other than ventilatory failure. Since hypoxemia is often present in the patient with ventilatory failure, the clinical signs of inadequate oxygenation are often simultaneously present. Hypothermia and loss of consciousness are common when the ventilatory failure is the result of an overdose of sedatives.

Ventilatory failure with rising PaCO2 affects the brain much like an anesthetic and results in somnolence and eventually coma. CLINICAL FEATURES Oxygenation Failure Inspection of the patient with severe hypoxemia typically reveals central cyanosis unless anemia is present and obscures the cyanosis. Central cyanosis is seen as a bluish discoloration of the tongue and mucous membranes. Anemia reduces the ability of clinicians to detect cyanosis because the bluish discoloration of tissues is due to desaturation of the hemoglobin.

Qxd 08/14/2006 02:13 PM Page 36 PMAC-122 27C:FABK010:Chapters:CH-02: TechBooks(PPG-Quark) Copyright © 2007 by F. A. Davis. 36 Chapter 2 Introduction to Respiratory Failure The amount of oxygen consumed and CO2 produced each minute is dictated by the metabolic rate of the patient. Exercise and fever are examples of factors that increase the metabolic rate and place more demands on the cardiopulmonary system. When the cardiopulmonary reserve is limited by disease, fever may represent an added stress that precipitates respiratory failure and tissue hypoxia.

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