Pulmonary Problem Solving I

Scenario Two

Patient Chart
AG is a 60-year-old male who has presented to the ED with shortness of breath of recent onset. He has a six year history of COPD and is on oxygen at home. Physical assessment reveals the following:, respiratory rate 32, slightly labored, temperature 98.9F. His SpO2 90% on while receiving oxygen via nasal cannula at 2 Lpm.

To complete the physical exam, use the Blood Pressure tab above to simulate taking the patient blood pressure and pulse rate. Then use the Auscultation tab to assess the lung sounds.

Twenty minutes after the patient presented to the ED, arterial blood is drawn for analysis. The following data is obtained (on nasal cannula at 2 Lpm):

pH: 7.29
PaO2: 59 mm
PaCO2: 72 mmHg
SaO2: 87
HCO3: 32 mEq
Hgb: 16.4 gm

Heart Rate:
Blood Pressure: /


Which of the following is the most likely diagnosis to make at this time?