A 14 year-old is experiencing a severe asthma attack. Although he is using accessory muscles to breath, auscultation of his chest reveals no audible wheezing. His heart rate is 160 and his respiratory rate is 52. Which of the following arterial blood gases represents the worst prognosis?
A pH = 7.52; pC02 = 28; p02 = 80
B pH = 7.44; pC02 = 38; p02 = 70
C pH = 7.60; pC02 = 18; p02 = 60
D pH= 7.40; pC02 = 40; p02 = 60
E pH = 7.27; pC02 - 62; p02 = 64
Answer: E
This patient has a RR of 52. If she is ventilating, she is blowing of C02 (an acid) and would be alkalotic and should have a low C02. A pH which is acidic with a pC02 which is elevated means that she is no longer ventilating at all (she needs mechanical ventilation or she will die).
Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already you can sign up by clicking Here.