Amber W. Hendrix
MMTC
Author Note
Case Study for RT 242 Respiratory Therapy Clinical II
Peritoneal Tuberculosis
I never got to speak directly to my case study. She was intubated when I first became aware of her case and she failed all attempts at weaning from the vent before she died. There was regrettably also a language barrier with the majority of her family as they spoke Haitian Creole which has roots in Portuguese, Spanish, Taino, and West African languages, which left me limited chances of communication with either the patient or her family. I was eventually able to speak with her cousin whom she had been staying with in Nashville. She had recently come to live in America from Port-au-Prince, Haiti. She was a young women, just …show more content…
M was not able to effectively communicate. She was currently taking the following list of medications.
• Atripla: combination drug containing efavirenz, emtricitabine, and tenofovir, used as an antiviral medication that is used to prevent HIV from reproducing in the body. Side effects vary from severe reactions being lactic acidosis and mild reactions consisting of flu-like symptoms.
• Bactrim: combination drug containing sulfamethoxazole and trimethoprim. They are an antibiotic used to treat bacterial infections
• Multivitamin: a combination of many different vitamins that are usually found in foods and other natural sources and are used as a supplement to the regular diet
• Iron: ferrous sulfate, a type of iron normally acquired from the foods we ingest that becomes part of our hemoglobin and myoglobin.
• Isoniazid: an antibiotic that is used to treat and to prevent tuberculosis. Side effects can consist of liver …show more content…
M was intubated due to respiratory failure, below is her vent settings and her ABG results that were collected after mechanical ventilation had been initiated.
Thursday October 9
ABG
pH: 7.307 PCO2: 28.5 PO2: 237.2 HCOᴣ: 13.9
SAO2 99.9%
Vent Settings
VC/AC f:24 VT: 400 Peep 5 O2: 50%
Her ABG shows she is in a partly compensated metabolic acidosis and her PO2 shows she is being over oxygenated. Her O2 levels could benefit from a lower setting. Her HR was at 167 and her blood pressure was 190/101 and with her heart rate being as high as it was we could not give her prescribed Duoneb treatment. She was not receiving any sedatives and her anxiety level was elevated, I do believe if some mild sedative had been given we had a chance at her heart rate decreasing enough to safely give her nebulizer. On the afternoon of Thursday the 9 of October, Ms. M was bronched. A flexible fiberoptic bronchoscope was used to visually inspect her tracheobronchial tree and to retrieve sputum samples for testing by bronchoalveolar lavage. Some of the sputum samples was used to test for acid-fast bacilli. Between the testing of the CSF collected on the 7th and the positive test results on the sputum, Ms. M was confirmed to have active Tuberculosis.
Friday October 10