Case # 1   Mrs. G, a 62-year-old female, was seen in the emergency department for complaints of increasing shortness of breath. Mrs. G states that seven years ago her family physician told her she had emphysema.  At home she is on oxygen via nasal cannula at 1 lpm, and a small volume nebulizer with albuterol sulfate four times a day. Her vital signs are as follows: HR 108/minute, RR 28/minute, BP 142/80 mmHg. She's on a 24% venturi

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Case # 1  

Mrs. G, a 62-year-old female, was seen in the emergency department for complaints of increasing shortness of breath. Mrs. G states that seven years ago her family physician told her she had emphysema. 

At home she is on oxygen via nasal cannula at 1 lpm, and a small volume nebulizer with albuterol sulfate four times a day. Her vital signs are as follows: HR 108/minute, RR 28/minute, BP 142/80 mmHg. She's on a 24% venturi mask.

 Mrs. G's ABG results indicate partially compensated respiratory acidosis moderate hypoxemia with a base excess of +5.

Part 1: PAO2 (oxygen partial pressure inside the alveoli) is 88.82 mmHg

Part 2: Her actual A-a gradient is 38.62 mmHg.
(Say normal for her 19.5)

Part 3: Her actual dead space to tidal volume ratio is 0.52
(Say normal range: 0.25 to 0.40)

What is clinically happening to the patient?

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