Hypoxia, hypercapnia and COPD

ssalinas

Just curious what others would do with the following diagnostic
statement:

Hypoxia with chronic hypercapnia due to chronic obstructive pulmonary
disease - receiving 3 l/min by nasal cannula

ABG pH 7.48
pCO2 64
pO2 72
HCO3 47.7
O2 Sat 95.0
BaseExc 20.6
FIO2 32

catladyrn

I might ask for alkalosis, mixed, or chronic respiratory failure, but otherwise it seems like a fairly unspecial ABG for a COPD patient.

Renee


Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center

katysuegood@gmail.com

my first thought was "chronic respiratory failure".

catladyrn

Whoops, meant to say metabolic alkalosis, not mixed. Probably they're overcompensating for their usual acidosis.

Renee


Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center

ssalinas

See this quite often and chronic respiratory failure is first thought also. All you have with the statement is COPD (496) and hypoxia (799.02). Is it special enough to query for the alkalosis or chronic respiratory failure? Who out there has the perfect respiratory failure query that would be appropriate?

robert.hodges2

I was thinking the same thing. It would depend on if they are on nebulizers, etc and how fast they decompensate without O2 and treatment.

Robert

Robert S. Hodges, BSN, MSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
 
"We are dealing with Veterans, not procedures; With their problems, not ours." --General Omar Bradley

robert.hodges2

Here is my query, but I won't claim it's perfect. LOL

It covers both acute and chronic failure.

Robert

Robert S. Hodges, BSN, MSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
 
"We are dealing with Veterans, not procedures; With their problems, not ours." --General Omar Bradley

lsipos@monument.health

Robert

Good morning! I noticed your query for respiratory failure, and I think that for "acute respiratory failure", (from my understanding), there does NOT have to be vent support. I know when our independent consultant group "CLARO" came through in July, that was one thing they reiterated, was that there does NOT have to be vent support for Acute failure. So, just thought it may be something that you would want to know. By no means am I implying I am correct, but just wanted you to be aware there is a disparity here...(go figure, that never happens)! If you find out otherwise, please let me know!

Juli Bovard RN CDS
Clinical Documentation Specialist
Clinical Effectiveness/Clinical Quality
Rapid City Regional Hospital
719-4390 (work)
786-2677 (cell)
"No Limit to Better......"

robert.hodges2

Use the word "and/or" between the criteria, not "and". What is listed are examples and guidelines, not the absolute criteria.

I hope that makes sense.

Robert

Robert S. Hodges, BSN, MSN, RN, CCDS
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
 
"We are dealing with Veterans, not procedures; With their problems, not ours." --General Omar Bradley

evanspx@sutterhealth.org

You may want to confirm this statement:

if history of COPD, pH

robert.hodges2

Good catch, thanks.

Robert