Reference no: EM133254256

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.

Discussion Questions

1. What clinical findings are likely in R.S. as a consequence of his COPD? How would these differ from those of emphysematous COPD?

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

3. What is the rationale for treating R.S. with theophylline and a ß2 agonist?

4. What effects would his respiratory disease have on his cardiovascular function?