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Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

The delicate balance between CO2 and oxygen is very interesting. I see students struggle with acidosis and alkalosis. Respiratory acidosis will be caused by decreased respirations, but metabolic acidosis will lead to increased respirations as the body tries to compensate. When looking at ABGs once can easily distinguish between the two, but when you look at the clinical picture (from the eyes of a student) they appear similar.

Please remember that to qualify for home oxygen the patient must meet specific guidelines. As nurses we tend to be cheerleaders for our patients, but when it comes to home oxygen we need to be their advocates. Medicare is the standard as far as requirements go, this is an example from Aetna.

1. **Qualifying laboratory values:

Continuous Oxygen:

1. Resting PaO2 less than or equal to 55 mm Hg or oxygen saturation less than or equal to 88%

2. Resting PaO2 of 56-59 mm Hg or oxygen saturation of 89% in the presence of any of the following

1. Dependent edema suggesting congestive heart failure

2. Erythrocythemia (hematocrit greater than 56%)

3. P pulmonale on the electrocardiogram (P wave greater than 3 mm in standard leads II, III, or aVF)

3. Resting PaO2 greater than 59 mm Hg or oxygen saturation greater than 89% only with additional documentation justifying the oxygen prescription and a summary of more conservative therapy that has failed.

Non-continuous Oxygen: (oxygen flow rate and number of hours per day must be specified)

4. During exercise: PaO2 less than or equal to 55 mm Hg or oxygen saturation less than or equal to 88% with a low level of exertion

5. During sleep: PaO2 less than or equal to 55 mm Hg or oxygen saturation less than or equal to 88% with associated complications, such as pulmonary hypertension, daytime somnolence, and cardiac arrhythmias.

Note: All qualification studies must be done while on room air unless medically contraindicated. Documentation of blood gas values can come from the doctor’s office, hospital or from an outpatient laboratory.

http://www.aetna.com/cpb/medical/data/1_99/0002.ht…

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