Directions: Write I for true or F for false in

Question 1 . Explain the pathophysiology leading to all the clinical manifestations with which David Nazzal presents. Use the information from the deranged vital signs shown in the A – G assessment and the ISBAR handover . A-G assessment Airway – Patient , own. Breathing -RR-30b/min,SPO278% on room air, increased shortness of breath (SOB) , Auscultation : Diminished breath sounds bilaterally, with wheezing and crackles in the lung bases. Using accessory muscles of respiration++ Circulation Heart Rate (HR) Regular – 128 b/min-Sinus tachycardia. BP – 168/85 mmHg. Capillary Refill Time 3 sec, peripherally cool, heart sounds dual no murmur. Disability -GCS-14/15 E4V4M6, confused and distressed + Exposure – Febrile, skin intact, IV cannula right cubital fossa Abdo: bowel sounds present in all four quadrants with a soft, nontender abdomen. Fluid – IVF fluids in progress TKVO, Nil by mouth. Glucose – BSL – 5.8 mmol/l . David presented to the emergency department. Upon assessment he was sitting in a tripod position with barrel chest. David presents with fever, sore throat, productive cough yellow phlegm and dyspnea. Background: David tested positive for covid-19 three days ago. symptoms had progressively worsened. David had similar episode a year ago with an acute exacerbation of (COPD) requiring hospitalization. David has increasing yellow phlegm. has self medicated with Ventolin inhaler symptoms not resolved. past history – COPD , hypertension, ex smoker 10 years ,

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