Multisystem Failure in Geriatrics

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Mrs. Baker’s immediate assessment would include ensuring a patent airway, adequate breathing and circulation, and a brief neurological status. Once the immediate assessment is complete then a secondary assessment is conducted that includes a full set of vital signs with focused adjuncts, pain control, a full head-to-toe assessment with a patient history.
Knowing that Mrs. Baker was recently started on lisinopril while already taking metformin and hydrochlorothiazide, the immediate assessment would include possible adverse reactions to the medications. Therefore, edema could be a possible factor when examining a patent airway. If Mrs. Baker’s airway is compromised in any way due to edema or an obstruction, it will be necessary to intubate
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This could be a valid cause of the patient’s symptoms of confusion, anxiety, and loss of consciousness. Additionally, a side effect of lisinopril while taking a diabetic medication such as metformin is hypoglycemia. However, we are going to assume that this is not the case because this would normally be identified during transport and the patient was initially alert upon arrival. Therefore, we would move onto the next critical issue, a stroke. A CT scan will assist in ruling out a stroke as well as coagulation lab results. Blood sugar results are also helpful in that levels below normal will mimic a stroke, whereas elevated levels above normal can complete a stroke further. The EKG will be evaluated for critical rhythms such as atrial fibrillation that can lead to a stroke or a MI that precipitates a stroke. Additionally, if a subarachnoid hemorrhage is suspected, a lumbar puncture can be utilized to evaluate blood in the CSF. However, we will assume that the CT scan and lumbar puncture has ruled out a stroke or subarachnoid hemorrhage. Therefore, my next assumption would be an adverse reaction to lisinopril based on recent addition of medication and increased reactions due to current diuretic.
First we will evaluate the tests that we have performed thus far and what these test could indicate based on assessment and treatment started. * Intubation: would be utilized for airway

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