Mr. S. is a retired 69-year-old county attorney who was on a buying trip with his wife for old, classic cars in the high, mountainous country of Colorado when he became extremely short of breath.

Mr. S. is a retired 69-year-old county attorney who was on a buying trip with his wife for old, classic cars in the high, mountainous country of Colorado when he became extremely short of breath. His alarmed wife took him to a multispecialty medical clinic for evaluation. On admission to the clinic, Mr. S. was restless and dyspneic. His chest had an increased anteroposterior dimension.

Mr. S.’s history revealed a habit of smok­ing 2 packs of cigarettes a day for 45 years. Dur­ing the past few years, Mr. S. had noticed a cough each morning on arising. Recently, while working in his flower garden, he had to stop at times to catch his breath. Even while watching television, he had experienced dyspnea. Also, he indicated a weight loss over the last 2 months.

A chest radiograph was taken, and pul­monary function tests were done. The chest radiograph revealed a flat, low diaphragm with lung hyperinflation but clear fields. Pulmonary func­tion tests showed decreased tidal volume and vital capacity, increased total lung capacity, and prolonged forced expiratory volume.

Mr. S’s condition deteriated and he was admitted to the hospital. On assessment, his Pulse oximeter indicated a reading of 89%. The nurse is aware that the pulse oximeter value is important but she knows that it is limited because it only measures one component of oxygenation. In order to have a more accurate picture of Mr. S’s overall oxygenation status, the nurse must assess ABGs and pulse oximeter values in relations to the Oxyhemoglobin dissociation curve.

Mr. S’s condition deteriated and he was admitted to the hospital. On assessment, his Pulse oximeter indicated a reading of 89%. The nurse is aware that the pulse oximeter value is important but she knows that it is limited because it only measures one component of oxygenation. In order to have a more accurate picture of Mr. S’s overall oxygenation status, the nurse must assess ABGs and pulse oximeter values in relations to the Oxyhemoglobin dissociation curve. The ABG values were ph 7.30, pO₂ 80, pCO₂ 50, HCO3 26mEq/L.

Mr. S was initially placed on nasal O2 @ 6 L and his pO2 was 76. As his condition declined, the nasal O2 administration was increased. Mr. S was later placed on a ventilator with positive pressure and PEEP. Which condition did it progress to? Justify your answer. (First Diagnosis was COPD, BUT NEED WHAT HE PROGRESSED INTO). Define P 50 and why is the value important?