There are a number of blood test results for this patient that are abnormal. The values that are higher than the expected range are HCO3 at 29 meq/L (normally 22-26), fasting glucose at 138 mg/dL (normally less than 100 mg/dL), the white blood cell count of 15,200/mm3 (normally between 5,000 and 10,000), and the pH of 7.50 (normally between7.35 and 7.45). The values that are lower than the expected range are creatinine at 0.9 mg/dL (normally 1.2-1.5), calcium at 8.7 mg/dL (normally 9-11), lymphocytes at 10% (normally 20-40%), PaO2 at 59 mm/Hg (normally 80-100), and PaCO2 at 25 mm/Hg (normally 35-45) (Giddens, 2015). The results for pH, HCO3 and PCO2 all suggest alkalinity. Based on the x-ray, from a pathophysiological perspective, this is likely to be associated with respiratory failure (Giddens, 2015), although the high fasting blood glucose value could suggest diabetes complications in combination with alkalinity. The white blood cell count of 15,200/mm3 and the reduced lymphocyte count are both indicative of infection, which in this patient appears to be pneumonia (Giddens, 2015).
There are a number of medications likely to be prescribed to this patient. The first is insulin, which can help to correct the high levels of blood glucose and reduce issues with alkalinity (Lewis & Kontoyiannis, 2013). The second is amphotericin B, which would be prescribed as an antifungal agent to deal with mucormycosis (Lewis & Kontoyiannis, 2013). Posaconazole or isavuconazole may also be given as a second line treatment against the fungal infection. There are also a number of recommended treatments. The first is surgery to remove the infected lung tissue (Skiada et al., 2013). Hyperbaric oxygen may also be used, particularly as it has been shown to be particularly effective in mucormycosis pneumonia in diabetics (Skiada et al., 2013). The patient should also monitor their blood glucose carefully and take effective diet and exercise precautions to reduce the incidence of complications from diabetes.

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  • Giddens, J. F. (2015). Concepts for Nursing Practice. Elsevier Health Sciences.
  • Lewis, R. E., & Kontoyiannis, D. P. (2013). Epidemiology and treatment of mucormycosis. Future Microbiology, 8(9), 1163–1175.
  • Skiada, A., Lanternier, F., Groll, A. H., Pagano, L., Zimmerli, S., Herbrecht, R., … Petrikkos, G. L. (2013). Diagnosis and treatment of mucormycosis in patients with hematological malignancies: guidelines from the 3rd European Conference on Infections in Leukemia (ECIL 3). Haematologica, 98(4), 492–504.