Mr ABC is hospitalized and is decompensated. Mr ABC is a 50 years old man admitted to the hospital w

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Mr ABC is hospitalized and is decompensated.

Mr ABC is a 50 years old man admitted to the hospital with 7 days history of worsening cough, high fever, and dyspnea. Upon admission he was noted to be tachypneic (RR 30 breaths/min), hypoxia with oxygen saturation 89% and is febrile (39 degree celsius). Chest X-ray: Infiltrates in both lower lobes.

CBC : WBC of 20,000. Treatment was initiated for community acquired pneumonia. Despite treatment he has worsening hypoxia which requires intubation and ventilatory support. Despite mechanical ventilation using high oxygen concentration, his arterial blood oxygen remains low. Chest X-ray from today shows progression of infiltrates throughout both lung fields. His WBC count is 35,000, he has fever 40 degree celsius, HR 120, bp 70/30, not responding to fluids, Levophed has just been started.

What additionl diagnosis does Mr ABC has?

What are the most likely cause of Mr ABC diagnosis?

Why is Mr ABC Hypoxic?

What is an A-a gradient, what does it tell you and what do you expect Mr ABC A-a gradient to be?

What is Mr ABC at an increased risk of developing? 

SCIENCE
HEALTH SCIENCE
NURSING
NURS 5315

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