Patient With Moderate Assignment Help: How to Answer This Question

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Original Question

A patient with moderate to severe COAD is being managed in the ward. Fill in the correct responses that pertain to the pathophysiology of the disease and its management. 1- In moderate to severe COAD there may be chronic (hypoxia-anaemia-pyrexia) as there is the destruction of the alveoli and chronic obstruction of the ( bronchioles-bronchus-trachea). 2- The patient may receive supplemental oxygen at home and, in the ward, they are managed with a goal of a SpO2 of 88-92%. The rationale for this is to prevent too much O2 inspiration which may lead to the complication of CO2 retention, which can lead to severe respiratory acidosis in some COAD patients. Respiratory acidosis can lead to narcosis and ( respiratory depression-respiratory alkalosis- tachypnoea). This occurs predominately because of V/Q mismatch (ventilation/perfusion mismatch), which means that underventilated alveoli (those damaged by the process of emphysema) start to get (increased blood supply – decreased blood supply -hyperventilated) leading to ( hypercapnic (high CO2)- hyperoxygenated (high O2) – hyperkalaemic (high potassium) ) blood entering the circulation. To prevent the problem of respiratory depression in COAD patients who are CO2 retainers, the nurse must select the oxygen therapy device and oxygen flow to meet the oxygenation goal.

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