86-year-old F patient in Santa Barbara, CA (sea level) has c…
86-year-old F patient in Santa Barbara, CA (sea level) has consolidation in middle and lower right lobes with crackles on auscultation right side. Patient is on appropriate dose of Vancomycin, (verified by troughs). Morning lab values indicate WBC = 17.2 k/μL. Patient is on HFNC 60% FiO2 50 LPM HR 128, RR 30, SpO2 89%, temp 39.4 C ABG: 7.35 / 45 / 53 / 25, HB = 14.5 Vol%. A. What 3 equations would you pick to assess this patient’s oxygenation status? B. There can be many potential reasons for an A-a gap. Why does this patient have A-a gap issues. Please list as many relevant issues as you can think of. C. Explain the role of right to left shunting for this patient. D. Would you expect this patient’s delivery of oxygen at the tissue level to be higher or lower? E. What disease does this patient have and what treatments might you suggest beyond the antibiotics already prescribed?
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