Mrs. Jane Dow is an inpatient in the University Hospital and has returned from OT (Operating Theatre) after having an open cholecystectomy for gallstones. She returned to the ward, and you have begun an assessment of this patient. She is still drowsy from the anesthetic and her current GCS is 14.
Her post op observations include: T 35.8, PR 124, RR 32 and shallow, BP is 95/50. She is complaining of sudden pleural pain 5/10 in the right ribs and difficulty breathing. On auscultation you find limited air entry to the right chest. Oxygen saturations are 92% on 2 litres of oxygen via the nasal prongs. Her wound dressing on the abdomen is clean and dry with only a slight wound ooze. She has a drain into the wound with is patent and has a small amount of dark blood in it.
Her weight is 80kgs. Her DOB is 23/01/1960. She is married to Henry who is aged 63 and works. They live in their own home.
Allergies- Nil
Current medications- nil
Past illnesses- GORD, gall stones and cholecystitis
Pathophysiology Question –
The arterial blood gas taken from Jane showed both a low O2 level (PaO2 = 70 mmHg) and a low CO2 level (PaCO2 = 18mmHg). Explain the pathophysiology leading to these abnormal findings (You need to explain how a pnuemothorax can change function of the respiratory system resulting in the changed gas levels).
After completing the assessment of this patient, the doctor has inserted a needle into the 2nd intercostal space to relieve the tension pneumothorax.
Your priorities of care will include the next 2 hours of care.