A 38-Year-Old Man Is Evaluated for Tachypnea

A 38-year-old man is evaluated for tachypnea.  The patient, a construction worker, fell off a roof while working yesterday.  He sustained an open femur fracture, which required urgent operative repair.  Medical history includes chronic low back pain for which he has been taking opioids.  Temperature is 36.7 C (98.1 F) , blood pressure is 130/90 mm Hg, pulse is 110/min, and respirations are 30/min.  Pulse oximetry is 99%.  On physical examination, the lungs are clear to auscultation.  Heart sounds are regular.  The abdomen is soft and nontender to palpation.  Arterial blood gas while the patient is breathing room air shows the following: Which of the following best explains the laboratory findings in this patient?

A) Excessive saline infusion
B) Illicit opioid use
C) Inadequate pain control
D) Pulmonary embolism
E) Sepsis

Correct Answer:

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