A patient was admitted to the hospital with chronic obstructive pulmonary disease. His O2was 55 and CO2 was 65. A new resident orders 54% oxygen via the venturi mask. One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation (CPR). Explain why the patient stopped breathing.
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In people who retain carbon dioxide because of pulmonary disease, arterial CO2 is chronically elevated and chemoreceptors become unresponsive to this chemical stimulus. In such cases, declining O2 levels act on the oxygen-sensitive peripheral chemoreceptors and provide the principle respiratory stimulus, or the so-called hypoxic drive. Pure oxygen will stop a person's breathing, because his respiratory stimulus (low O2 levels) would be removed.
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