KU is a 59-year-old female who has come to the emergency department complaining of shortness of breath that has become progressively worse over the past two days. She has a ten year history of COPD. Her last hospitalization was two months ago.
Assessment in the ED reveals the following: respiratory rate 32 and slightly labored, temperature 98.8F F, SpO2 (on room air) 86%. She is alert and oriented with an occasional nonproductive cough. Continue the exam using the auscultation and blood pressure tab.
Arterial blood gases are obtained with the following data:
pH 7.28; PaO2 49 (on room air)
PaCO2 74; SaO2 85%
HCO3 34; Hgb 16.4
The patient is given three aerosol treatments via small volume nebulizer with 2.5 mg albuterol plus 0.5 mg ipratropium with little change in his condition.