Medical Case: Jennifer Hoffman

This document discusses a medical case involving Jennifer Hoffman. It covers topics such as examining the state of the patient through clinical assessments, causes of hypoxemia, nursing care for shortness of breath, and a review of laboratory results.

Running head: MEDICAL CASE: JENNIFER HOFFMAN 1
Medical Case: Jennifer Hoffman
Student’s Name
University Affiliation

MEDICAL CASE: JENNIFER HOFFMAN 2
Medical Case: Jennifer Hoffman
Question one
To determine or examine the state of the patient, the clinical assessments are always
considered by physicians and nurses (Clark, Röijezon & Treleaven, 2015). This helps the doctor
to know whether the client’s condition is recouping or worsening. If the patient is recovering, the
heart rate, oxygen saturation, and hypoxia should be almost normal, however, in Jennifer
Hoffman’s case, the conditions are worsening as the assessment findings indicate a decrease in
oxygen saturation, increased heart rate, and hypoxia. In this scenario, the assessment findings
that would mean the client’s condition is worsening include low oxygen saturation, hypoxia, an
increase in heart rate, tachycardia, wheezing and coughing.
Low oxygen level in the body also referred to as hypoxemia. A decreased saturation of
oxygen than normal means that the body is not working properly and thus needs examination.
The condition can cause shortness of breath as it is shown in this scenario. Other issues that can
be brought as a result of low saturation of oxygen level may include interference of heart and
brain functions (Clark, Röijezon & Treleaven, 2015).
There are various causes of hypoxemia conditions. Some of the common causes include heart
defects, lung conditions such as bronchitis and asthma, the location of altitude, inflammation or
use of strong pain medications. There are several symptoms of hypoxemia which include
shortness of breath, confusion, wheezing, coughing, fast heartbeat, bluish color in skin and
headache (Hennessey & Japp, 2016). Such symptoms will show indicate that the patient
condition is worsening and thus will require medical attention.

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After observing such conditions, the doctor is supposed to take quick action by examining the
patient. Also, the physician is supposed to provide with the right medication that can raise the
levels of oxygen in the blood (Hennessey & Japp, 2016).
Question two
When a patient develops a rapid onset of shortness of breath, there are specific priorities that a
nurse should immediately undertake. Shortness of breath also referred to as dyspnea can happen
to anybody and several factors cause it. These factors may include asthma, congestive heart
failure, intestinal lung disorders, and pulmonary artery hypertension among many others.
The nursing care should first consider a tremendous impact on improving the efficiency of the
client’s respiration and ventilation to increasing the client’s chances of recovery.
The doctor can examine the patient by the process of lungs auscultation. Lung auscultation
involves the procedure where a physician or a nurse uses a stethoscope to listen to lung sounds.
The process is very critical for the physician or a nurse as it will disclose the abnormal sounds
like crackles, wheezes or rhonchi. The main aim of using this type of clinical assessment is to
determine the respiratory system that is breath sounds and the circulatory system which is heart
sounds. Besides, auscultation is also essential in examining the sounds of the gastrointestinal
system that is the bowel sounds which does not apply in this case (Larkin, & Zimmanck, 2015).
Secondly, it will be of importance for the nurse to measure the ECG of the patient. This involves
the process of measuring the electrical activity of the heart and its rhythm which will provide an
idea of whether the client has hypertension or myocardial infarction (Johnson, 2017). The next
step the physician can undertake is to can make sure there is patency of airway and enough
supply of oxygen and then dispense the medications to the patient as ordered.

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Question three
By reviewing Jennifer Hoffman’s laboratory results, there are precise results which can be
identified as abnormal and be related to her clinical presentation and come up with the condition
she might be having (Urden, Stacy & Lough, 2017). As pert her laboratory results, Arterial
Blood Gas (ABG) showed a pH of 7.37, Partial pressure of carbon dioxide (PCO2) is 57 and
bicarbonate (HCO3) levels of 27.2. For a standard arterial blood gas interpretation, the normal
ranges include pH of 7.35- 7.5, PaCO2 of 11 -13 kph and HCO3 of 22 - 26mEq/L (Hennessey &
Japp, 2016).
In this case, ABG results showed a pH of 7.37 which is within the reasonable limits and
HCO3 27.2 which is high and PCO2 57 which is also extremely high. I can interpret these
findings as Compensated Respiratory Acidosis (Johnson, 2017). In a compensated Respiratory
Acidosis, the pH remains within the normal range; however, the PCO2 becomes high (Marik,
2015). The condition mostly occurs when the lungs fail to remove out enough carbon dioxide
produced by the body. In this case, the compensated respiratory acidosis occurs as a result of the
patient’s asthma condition which has caused severe airway obstruction thereby resulting in
decreased air movement (Patel & Sharma, 2019).

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References
Clark, N. C., Röijezon, U., & Treleaven, J. (2015). Proprioception in musculoskeletal
rehabilitation. Part 2: clinical assessment and intervention. Manual therapy, 20(3), 378-
387.
Hennessey, I. A., & Japp, A. G. (2016). Arterial Blood Gases Made easy, Elsevier, 2016:
Arterial Blood Gases Made easy(Vol. 1). Bukupedia.
Johnson, R. A. (2017). A quick reference on respiratory acidosis. Veterinary Clinics: Small
Animal Practice, 47(2), 185-189.
Larkin, B. G., & Zimmanck, R. J. (2015). Interpreting arterial blood gases successfully. AORN
journal, 102(4), 343-357.
Marik, P. E. (2015). Arterial Blood Gas Analysis. In Evidence-Based Critical Care (pp. 329-
347). Springer, Cham.
Patel, S., & Sharma, S. (2019). Physiology, Respiratory Acidosis. In StatPearls [Internet].
StatPearls Publishing.
Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical care nursing: diagnosis and
management. Elsevier Health Sciences.

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