PCCN questions with correct answers

Two days following a near-drowning accident, a pt is dyspneic, using accessory muscles, expectorating large amounts of secretions and reporting feeling of impending death. Changes to the assessment data include RR- 24 TO 36 CXR clear to bilateral diffuse infiltrates ABG 40% face mask or 100% non-rebreather mask pO2 120 mm Hg to 56 mm Hg pCO2 33 mmHg to 56 mmHg pH 7.42 to 7.35 HCO3 24 meq/L to 27 mEq/L Which of the ff do these changes most likely represent A. aspiration pneumonia B. pulmonary em CORRECT ANSWER D. The onset of symptoms occured within 48 hours of the incident. THe bilateral diffuse infiltrates and ABG results indicating hypoxemia and CO2 retention are all consistent with ARDS. Aspiration pneumonia should include hypoxxemia, respiratory alkalosis. The CXR results would reveal an area of opacity with aspiration pneumonia rather than diffuse infiltrates. Interstitial lung disease invlolves an inflammation of supportive tissue between the air sacs rather than inflammation in the air sacs themselves. Symptoms would be SOB and a dry cough. A pt reports chest pain that is sharp, constant, worse when lying down and alleviated with sitting up and leaning forward. The most likely cause of these findings is A. ACS