Quiz 50: Oxygenation
Johti Singh is a middle-aged woman who has a medical history of having the bad cold for many weeks, which is still persistent. The primary assessment of any patient with respiratory problems involves the health history of the client, her physical examination and performing various diagnostic procedures. Ms. Singh has been a consistent cigarette smoker for a long time. She also showed the signs of rapid respirations, adventitious and diminished breath sounds and appearance of thick yellow sputum. These symptoms depict the condition of ineffective airway clearance. Also, she has been diagnosed with pneumonia. Other abnormal signs such as elevated temperature, rapid, labored respirations, fatigue and mild dehydration are also reported. These observations reveal a condition, which is more serious than a bad cold. A bad cold is not supposed to extend for such a long time and should not be accompanied with pneumonia.
Pneumonia refers to a medical condition in which, the ventilation of the distal alveoli gets impaired due to the clogging of the airways by the microorganisms in the lower respiratory tract. It is generally associated with edema, inflammation and excess of mucus production. The respiratory system is structurally separated into two regions, the upper and the lower respiratory tract. The upper portion of the respiratory tract comprising of nose, pharynx, mouth and larynx acts as a barrier for the entry of microorganisms into the lower respiratory tract. The two such mechanisms are mentioned as follows: 1. The presence of hair at the entrance of the nares helps in trapping the large particles in the air. A sneeze reflex is also initiated due to the presence of irritants in the nasal passage. Sneezing helps in the rapid exit of a large volume of air through the mouth and nose, thus, clearing the nasal passages. 2. The lymphoid tissue present in the pharynx involving the nasopharynx and the oropharynx helps in the trapping and destroying the pathogens entering with the air.
Hypoxia refers to a condition in which the oxygen supply to all the tissues of the body is insufficient. This is a severe case of hypoxemia when the cardiovascular system is unable to compensate the oxygen deficiency in blood. Hypoxemia refers to a condition in which the level of oxygen in the blood decreases due to impaired diffusion of oxygen at the alveolar-capillary level. This condition can be characterized by low hemoglobin level, pulmonary edema, increased heart rate as well as cardiac output. Dyspnea refers to a condition in which the client experiences difficulty in breathing. Patients suffering from dyspnea show signs such as flaring of the nostrils, increased heart rate, labored appearing breathing, diaphoresis and cyanosis. Hence, the options 1, 2 and 3 are incorrect. Since, the client is suffering from chronic pulmonary disease and has reported appearance of a blush tinge around the lips; this condition can be most appropriately described as cyanosis. Cyanosis can also be identified by bluish discoloration of the nail beds, skin and mucous membranes, which occurs due to reduced hemoglobin oxygen saturation. Hence, the correct answer is option .