Case Study Icu Mr Stewart
Oxygen Supply and Demand Analysis
Oxygen Supply
To determine Mr. Stewart’s overall oxygen supply, we assessed his cardiac output and arterial oxygen content. Each of these components contribute to oxygen supply and will be discussed in more detail below.
Cardiac Output
Cardiac output is the amount of blood ejected from the heart in one minute and is calculated by multiplying stroke volume and heart rate (Gillespie, 2012b). Stroke volume is influenced by preload, afterload, and contractility.
Preload. Over the past two days in the ICU Mr. Stewart has been receiving IV fluids at 150cc per hour. His chest and lungs sounds present as course and wet and as evident from Mr. Stewart’s urine output of 2000cc within an hour and fifteen after catheterization, …show more content…
With Mr. Stewart having problems with his ventilation, we would expect that his alveoli are not being fully ventilated which results in a shunt-like units. We currently do not have any evidence indicating that alveolar dead space is occurring. With his chest and lung sound sounding coarse and wet throughout, Mr. Stewart’s diffusion may be impaired as we would expect an increased thickness of the a-c membrane, which would decrease his gas exchange. The doctor’s order for O2 at 100% via mask would increase the driving pressure of oxygen to improve Mr. Stewart’s diffusion. Overall based off the data provided, Mr. Stewart is experiencing a gas exchange …show more content…
Oxygen in blood is transported by hemoglobin and is influenced by oxygen and hemoglobin affinity and the patient’s hemoglobin level. The oxyhemoglobin dissociation curve illustrates the relationship between the binding and release of oxygen to hemoglobin and is affected by several factors, including temperature, pH, PaCO2, and 2, 3-DPG levels (Gillespie, 2012b). With Mr. Stewart’s temperature, being slightly elevated at 38, his CO2 level 32, we would expect a slight shift right on the oxyhemoglobin dissociation curve. A shift to the right indicates a decrease affinity for oxygen and as a result, available oxygen is readily released into the plasma and becomes available for the body’s tissues (Gillespie, 2012b). Also Mr. Stewart’s hemoglobin in currently low at 100.
Oxygen Demand
Oxygen demand can also be viewed as the metabolic demand of the body, which is commonly increased due to increased temperature, increased physical activity, and increased physiological or psychological stress (Gillespie, 2012b). Mr. Stewart’s oxygen demand is increased. He has an elevated temperature of 38.0. He also has increased stress physiological and perceived as he is experiencing chest pain and shortness of
Oxygen Supply
To determine Mr. Stewart’s overall oxygen supply, we assessed his cardiac output and arterial oxygen content. Each of these components contribute to oxygen supply and will be discussed in more detail below.
Cardiac Output
Cardiac output is the amount of blood ejected from the heart in one minute and is calculated by multiplying stroke volume and heart rate (Gillespie, 2012b). Stroke volume is influenced by preload, afterload, and contractility.
Preload. Over the past two days in the ICU Mr. Stewart has been receiving IV fluids at 150cc per hour. His chest and lungs sounds present as course and wet and as evident from Mr. Stewart’s urine output of 2000cc within an hour and fifteen after catheterization, …show more content…
With Mr. Stewart having problems with his ventilation, we would expect that his alveoli are not being fully ventilated which results in a shunt-like units. We currently do not have any evidence indicating that alveolar dead space is occurring. With his chest and lung sound sounding coarse and wet throughout, Mr. Stewart’s diffusion may be impaired as we would expect an increased thickness of the a-c membrane, which would decrease his gas exchange. The doctor’s order for O2 at 100% via mask would increase the driving pressure of oxygen to improve Mr. Stewart’s diffusion. Overall based off the data provided, Mr. Stewart is experiencing a gas exchange …show more content…
Oxygen in blood is transported by hemoglobin and is influenced by oxygen and hemoglobin affinity and the patient’s hemoglobin level. The oxyhemoglobin dissociation curve illustrates the relationship between the binding and release of oxygen to hemoglobin and is affected by several factors, including temperature, pH, PaCO2, and 2, 3-DPG levels (Gillespie, 2012b). With Mr. Stewart’s temperature, being slightly elevated at 38, his CO2 level 32, we would expect a slight shift right on the oxyhemoglobin dissociation curve. A shift to the right indicates a decrease affinity for oxygen and as a result, available oxygen is readily released into the plasma and becomes available for the body’s tissues (Gillespie, 2012b). Also Mr. Stewart’s hemoglobin in currently low at 100.
Oxygen Demand
Oxygen demand can also be viewed as the metabolic demand of the body, which is commonly increased due to increased temperature, increased physical activity, and increased physiological or psychological stress (Gillespie, 2012b). Mr. Stewart’s oxygen demand is increased. He has an elevated temperature of 38.0. He also has increased stress physiological and perceived as he is experiencing chest pain and shortness of