Problem:
pH7.55 PaCO2 30 mm Hg PaO2 65 mm Hg What is the cause of this metabolic state? Ali is a 37 yo man, who presents to the nurse practitioner at the Family Care Clinic. Case ing of increasing SOB, wheezing, fatigue, cough, stuffy nose, watery eyes, and postnasal drainage-all of which began four days ago. Three days ago, he began monitoring his peak flow rates several times a day. His peak flow rates have ranged from 200 to 240 L/minute (baseline, 340 L/minute) and often have been at the lower limit of that range in the morning. Three days ago, he also began to self-treat with frequent albuterol nebulizer therapy. He reports that usually his albuterol inhaler provides him with relief from his asthma symptoms, but this is no longer sufficient treatment for this asthmatic episode. PMH significant for: Diagnosed with asthma at age 18 months Moderate persistent asthma since age 19 Has been hospitalized 3 times (with 2 intubations) in the past 3 years for acute bronchospastic episodes and has reported to the emergency room twice in the past 12 months Perennial allergic rhinitis 15 years