Case Study Instructions: Read the Case Study and then use the information provided in Case Study and authoritative resources (minimum of 3) to answer the presented questions. Cite all resources supporting your responses to all case study questions using APA format. Remember to paraphrase any content that is cited.Case Study 2: Older Adult Patient with COPD and Risk for Heart FailureEvan Reddington is a 68-year-old Black male who was transported to the emergency department by ambulance. His presenting problems include severe dyspnea and lethargy. He has a productive cough with expectoration of thick yellow sputum. Mr. Reddington reports that he has been experiencing increasing difficulty breathing for the past week. He also reports that he has been experiencing alternating periods of sweating and chills.Mr. Reddingtons medical history includes chronic bronchitis, hypertension, and a 40-pack-year smoking history. Although he quit smoking cigarettes ten years ago, his condition has continued to deteriorate since that time. His history also includes myocardial infarction (MI) five years ago, for which he underwent successful angioplasty with stent placement in two coronary vessels. He denies any episodes of chest pain since his angioplasty.Mr. Reddingtons medications include a combined albuterol/ipratropium MDI, nebulized albuterol prn, captopril, and hydrochlorothiazide. Mr. Reddington is allergic to penicillin. He denies latex allergy. He is currently receiving supplemental oxygen at 4 L/minute via nasal cannula. He reports the supplemental oxygen is helping me feel like Im getting more air into my lungs.Mr. Reddingtons vital signs include blood pressure (BP) 174/95, heart rate (HR) 98, respiratory rate (RR) 30, oxygen saturation (SaO2) 91% on 4 L/min supplemental O2, and temperature (T) 101.1 Fahrenheit (38.4 Celsius).Initial laboratory and diagnostic tests for Mr. Reddington include:Complete blood count (CBC) with differential
Serum electrolyte panel
Arterial blood gases (ABGs)
Sputum analysis with culture and sensitivity
Chest X-ray
Mr. Reddingtons arterial blood gas (ABG) results include:pH: 7.37
pCO2: 58 mmHg
HCO3- : 36 mEq/L
pO2: : 98 mmHg
As you reveal his available laboratory results, you note that Mr. Reddingtons CBC results reveal secondary polycythemia.What are three major causes of chronic bronchitis?
Which acid-base imbalance is reflected by Mr. Reddingtons ABG results? Is this imbalance compensated or uncompensated? Explain your response.
What is secondary polycythemia? How does Mr. Reddingtons chronic bronchitis most likely contribute to the development of secondary polycythemia?
How does hypercarbia, which is characteristic of chronic bronchitis, increase Mr. Reddingtons risk for developing heart failure (HF)? If only one ventricle fails, which side of this patients heart is most likely to be involved and which manifestations are associated with this condition?
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