The AGNP is seeing a patient who has 30-pack-year smoking hi…

The AGNP is seeing a patient who has 30-pack-year smoking history. He reports a chronic cough with frequent sputum production, essentially daily, especially in the winter months, from October to March. Symptoms started when he was around 50 years old; he is now 54. Which of the following diagnoses does the NP suspect? 

A 190-lb (86-kg), 68-year-old man (IBW = 80 kg) is admitted…

A 190-lb (86-kg), 68-year-old man (IBW = 80 kg) is admitted to the hospital. He is placed on mechanical ventilation for acute respiratory failure compounded by metabolic acidosis. It is determined that he has a renal disorder. The physician orders peritoneal dialysis. In the interim, the physician asks the respiratory therapist to target a pH of 7.35 with assisted ventilation. Initial assessment of the patient resulted in the following ABG: pH = 7.22, PaCO2 = 38 mm Hg, HCO3− = 15 mEq/L, PaO2 = 98 mm Hg on FIO2 = 0.25.The ventilator settings are VC-CMV, f = 24 breaths/min, VT = 600 mL, FIO2 = 0.25.ABG results on this new setting are pH = 7.37, PaCO2 mm Hg = 23, HCO3− = 13.5 mEq/L, PaO2 = 115 mm Hg. A flow-time graphic shows the following: What is the problem, and what would you suggest to correct this problem and still help the patient?