Critical Illness Case Study
Development of the Patients’ Critical Illness
Following Stans’ return from theatre for the second time the nurse repeated their ABCDE approach (Resuscitation Council (UK) ,2015) and is as follows
Airway – The nurse identified that the airway remained secure post operatively as he remained intubated with an ETT. All breaths were being delivered ia the ventilator with Stan making nil spontaneous breaths.
Breathing – The nurse identified through auscultation that he had bilateral equal air entry. Stan was breathing adequately through the ventilator as there was no audible noise demonstrating a wheeze or rattling. Although Stans’ oxygen saturations were 94% his oxygen requirements had increased to 70% fiO2 and an EtCO2 was 3.7kpa. His respiratory …show more content…
The metabolic acidosis can be classed as being of an acute nature as it is only lasting for the period between minutes to several days as set out by Kraut and Madias (2010) classification. Kraut and Madias (2010) state that chronic forms of metabolic acidosis last weeks to years. Kraut and Madias (2010) identified also that when metabolic acidosis is of an acute nature it is likely due to the overproduction of organic acids such as lactic acids or ketoacids. Kraut and Madias (2010) add that acute metabolic acidosis affects the pathophysiology of the patient through a reduction in cardiac output, hypotension due to arterial dilatation, a decrease in adenosine triphosphate (ATP) production, alteration to oxygen delivery, weakening of the immune system and immune response and an increased risk of …show more content…
The respiratory control of pH is an effective buffer due to how quick it responds to changes in pH. Pierce et al (1970) identified that metabolic acidosis automatically creates hyperventilation to try and reverse the effects of acidosis. This in turn will decrease pCO2 creating secondary hypocapnia. Maidas, Schwarts and Cohen (1977) noted that the hypocapnia can be beneficial as it slows the reduction in blood pH but the bodies renal response leads to a decrease in bicarbonate (HCO3). Maidas, Schwarts and Cohen (1977) identified that this may cause a more acidic pH than would happen in the absence of hyperventilation. Peripheral circulation will be affected by hypocapnia as carbon dioxide stimulates constriction of arterioles. Burnum, Hickam and McIntosh (1954) identified that hypercapnia causes hyperventilation causing peripheral blood pressure to drop leading to a reduction in blood and oxygen delivered to the
Following Stans’ return from theatre for the second time the nurse repeated their ABCDE approach (Resuscitation Council (UK) ,2015) and is as follows
Airway – The nurse identified that the airway remained secure post operatively as he remained intubated with an ETT. All breaths were being delivered ia the ventilator with Stan making nil spontaneous breaths.
Breathing – The nurse identified through auscultation that he had bilateral equal air entry. Stan was breathing adequately through the ventilator as there was no audible noise demonstrating a wheeze or rattling. Although Stans’ oxygen saturations were 94% his oxygen requirements had increased to 70% fiO2 and an EtCO2 was 3.7kpa. His respiratory …show more content…
The metabolic acidosis can be classed as being of an acute nature as it is only lasting for the period between minutes to several days as set out by Kraut and Madias (2010) classification. Kraut and Madias (2010) state that chronic forms of metabolic acidosis last weeks to years. Kraut and Madias (2010) identified also that when metabolic acidosis is of an acute nature it is likely due to the overproduction of organic acids such as lactic acids or ketoacids. Kraut and Madias (2010) add that acute metabolic acidosis affects the pathophysiology of the patient through a reduction in cardiac output, hypotension due to arterial dilatation, a decrease in adenosine triphosphate (ATP) production, alteration to oxygen delivery, weakening of the immune system and immune response and an increased risk of …show more content…
The respiratory control of pH is an effective buffer due to how quick it responds to changes in pH. Pierce et al (1970) identified that metabolic acidosis automatically creates hyperventilation to try and reverse the effects of acidosis. This in turn will decrease pCO2 creating secondary hypocapnia. Maidas, Schwarts and Cohen (1977) noted that the hypocapnia can be beneficial as it slows the reduction in blood pH but the bodies renal response leads to a decrease in bicarbonate (HCO3). Maidas, Schwarts and Cohen (1977) identified that this may cause a more acidic pH than would happen in the absence of hyperventilation. Peripheral circulation will be affected by hypocapnia as carbon dioxide stimulates constriction of arterioles. Burnum, Hickam and McIntosh (1954) identified that hypercapnia causes hyperventilation causing peripheral blood pressure to drop leading to a reduction in blood and oxygen delivered to the