Which patient out of the two would you prioritize your care? Why? Patient #1: 38

Question

Which patient out of the two would you prioritize your care? Why?

Patient #1: 38 year old patient admitted with complaints of shortness of breath and fatigue. Pt brought into emergency room by family member. Initial assessment significant for pulse oximetry of 85% on room air. ABG: pH 7.38, CO2 35.6, Bicarb 24, PO2 68, BE -1, SaO2 87%. Pt placed on 70% FiO2 via trach mask with an improvement of SaO2 to 90%. Chest radiograph demonstrates an infiltrate in the right middle lobe indicative of PNA. WBC 12,000, Hgb 9.8, Hct 27, Plt 120. Patient will be admitted to pulmonary step-down for management of the pneumonia (PNA).

PMHx: COPD, HTN, Laryngeal CA with radical neck resection and tracheostomy performed in 2000.

Patient #2: 55 year old male presented to ED with complaints of SOB. Initial assessment revealed decreased breath sounds to left lower lobe and SaO2 of 88% on room air. Chest radiograph revealed large left pleural effusion. Pleural chest tube placed to – 20 cm suction. Patient admitted to medical floor for management pleural effusion.

PMHx: Heart Failure, AFIB, Type 2 DM

Explanation / Answer

Patient #2

the reason is

The first patient is a CA patient and is stabilised with oxygen and PNA can be managed with antibiotics and other supportive medicines.

The second patient needs more attention since he has a medical history of heart failure. the complaint that he came up with shortness of breath, which can suspect a possible chance of heart failure or AFIB ( seeing the facts of given medical history ). So the immediate response is required immediately to this patient to avoid collapse.

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