Answer:
Arterial blood gas (ABG) results from a 68-year-old woman with difficulty breathing show:
- Oxygenation (PaO₂): hypoxemia
- pH: acidosis
- PaCO₂: Hypercapnia
- HCO₃⁻: normal
whose interpretation is: <u>respiratory acidosis</u>.
Hypercapnia can produce symptoms such as confusion, drowsiness or lethargy, headache, nausea and vomiting and, in severe states, can cause severe unconsciousness and coma.
Explanation:
Respiratory acidosis is due to a failure in the breathing process that produces <u>hypoventilation</u>, decreasing the partial pressure of oxygen (PaO₂) —hypoxemia— and increasing the partial pressure of CO₂ (PaCO₂), called hypercapnia.
- <u><em>Acidosis</em></u><em> is the result of the accumulation of CO₂ in the body, which is reflected as a decrease in </em><em>pH</em><em> below 7.35, with no change in bicarbonate content.</em>
- <u><em>Hypoxemia</em></u><em> is the decrease of PaO₂ below 60 mmHg.</em>
- <u><em>Hypercapnia</em></u><em> is the increase of PaCO₂ in ABG above 45 mmHg.</em>
- <em>Normal </em><em>bicarbonate</em><em> </em><em>(HCO₃⁻) </em><em>values range from 22 to 28 mEq/L in ABG. This compound can be altered in metabolic acidosis.</em>
<u>Hypercapnia mainly affects the nervous system</u>, producing symptoms that alter the state of consciousness of the affected, also producing headache and even nausea and vomiting.
The guidelines state that if the type of diabetes is not documented, the default is type 2.
The guidelines also instruct to use additional codes to identify long-term control with insulin (Z79. 4) or oral hypoglycemic drugs (Z79. 84).
The type of diabetes mellitus should always be clearly documented in the medical record for each date of service. However, if the type of diabetes mellitus is not documented in the medical record, the default ICD-10 diagnosis code is E11, type 2 diabetes mellitus.
Secondary diabetes can be defined as a diabetic condition that develops after the destruction of the beta-cells in the pancreatic islets and/or the induction of insulin resistance by an acquired disease (e.g. endocrinopathies) or others.
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