Pathophysiological Processes Demonstrating Bob’s Clinical Status

Case Study 1 Name of Student Institution Affiliation Case Study 1 1. “Pathophysiological Processes Demonstrating Bob’s Clinical Status” The principle pathophysiological processes involved in the clinical status of Bob include COPD exacerbations, violations of gas exchange, and pulmonary hypertension. The violations of gas exchange are presented by oxygenation and ventilation status. The SpO2 level indicates the estimated oxygen amount present in the blood, i.e. “peripheral capillary oxygen saturation” (Harvey, Salehizadeh, Mendelson, & Chon, 2019). The normal value for SpO2 lies between 95 to 100 per cent. However, the SpO2 level of Bob is 89 percent. Therefore, a nebulizer mask has been placed at the rate of 8L/min. Support is important to emphasize that the main problem with COPD is pulmonary hyperinflation, i.e., an increase in lung volumes. Consequently, it leads to flattening of the primary respiratory muscle or diaphragm, i.e., moving it to a less efficient the null position on the curve length tension (Cushen et al., 2016). The COPD pulmonary hyperinflation leads to the creation of an internal positive pressure at the end of expiration that in turn increases the load on the breathing apparatus leads to increase respiratory rate. 1.1. ABG findings of Bob The ABG values are found to be slightly abnormal. For instance, Bob has a pH value of 7.23, while the normal range is 7.38 - 7.42. His PaCO2 (78 mmHg) is excessively increased from the normal range of 38 - 42 mmHg. The bicarbonate level is 29 mmol/L which is slightly increased than the normal values, i.e. 22 - 28 mmol/L (Tilanus et al., 2017). Furthermore, the partial pressure of oxygen is found to be 55 mmHg, which is also decreased as compared to the normal range of 75 - 100 mmHg 1.2. Hemodynamic Parameters Furthermore, considering the hemodynamic parameters, it has been noticed that Bob’s blood pressure is 183/97 mmHg which violates the normal range of 120/80 mmHg (Son et al., 2018). In addition, the pulse rate is 124 beats per min that is also excessively increased, while the normal range is 60 to 100 beats per minute. The observation of peripheral edema in the patient is a strong indicator of cardiac hemodynamics (Sterns, Emmett, Forman, 2016). Furthermore, the patient’s Jugular Venous Pressure was also elevated and was presenting the signs of sinus tachycardia. 1.3. Neurological Observations The neurological observation reveals that the patient is mentally disturbed. He is not orientated to the person, place, and time. Also, he is showing drowsiness. He was looking unwell, no well-orientation with time and place; lethargic; speaking short sentences; breathing with obvious accessory muscle use; and having prolonged expiratory phase 2. “Physiological Effects of BiPAP and Significance of Non-Invasive Ventilation in Bobs Condition” 2.1. Physiological Effects of BiPAP According to the Stanford Healthcare (2019), the patients with complicated COPD require the health care professionals to use specialized techniques to manage their respiratory rates. The “BiLevel Positive Airway Pressure” (BiPAP) mode is set by the expiratory pressure level which corresponds to the positive pressure at the end of exhalation (Expiratory positive airway pressure; ...