[Solved]: Case Study A 65-year old Ahmad, who recently had an…

Case Study A 65-year old Ahmad, who recently had an episode of choking was presented to the Emergency Department this morning with worsening shortness of breath, fever, productive cough with green sputum and a new onset of altered mental status. Ahmad is well-known to have hypertension for 11 years, and he was diagnosed with heart failure 4 years ago. The primary assessment of Ahmad revealed the following vital signs: SpO2 65% on room air, BP 160/95 mmHg, Pulse 115 beats/min, RR 27 breaths/min, and Temperature 39.2 deg C. His respirations were labored with the accessory abdominal muscle use. His wife stated that Ahmad has been weak for the last few days, getting mixed up and saying inappropriate things. She also noted that her husband has not been taking enough fluids. Ahmad was commenced on CPAP of 5 cm H2O, but his respiratory conditions didn’t improve, and his oxygen desaturation got worse. Ahmad’s CXR showed worsening perihilar airspace opacity, atelectasis, and pulmonary edema. An ABG and venous blood samples were taken (the results are shown in the table below). Ahmad was diagnosed with Acute Respiratory Distress Syndrome (ARDS), whereby he was immediately transferred to the ICU for intubation and mechanical ventilation.