Case Study Mr Walters, aged 68 years, has been unwell with a viral illness for 4 days. He has had multiple loose bowel actions over the last few days, as well as experiencing some nausea and vomiting. He has been unable to tolerate any food since becoming unwell, and has only been able to drink some small, infrequent sips of water. His skin is pale and cool to touch, and he is agitated and drowsy. History Mr Walters has a past history of an anterior myocardial infarction, hypertension, and a recent echocardiogram confirmed a left ventricular ejection fraction of 35%. His usual medications are: bisoprolol 2.5mg daily, ramipril 5mg mane, atorvastatin 40 mg nocte, and aspirin 100 mg mane. You are the critical care nurse responsible Mr Walters’ care. Your initial assessment findings are: respiratory rate: 30 breaths per minute blood pressure: 93/57 mmHg pulse: 106 bpm (regular) SpO2: 95% on room air temperature: 37.6 degrees Celsius Glascow Coma Scale (GCS): 15 Mr Walters appears to be hypovolaemic, as evidenced by hypotension, tachycardia and tachypnoea. With specific reference to Mr Walters’ history and presentation, explain the physiological causes of his hypotension, tachycardia and tachypnoea.

Case Study Mr Walters, aged 68 years, has been unwell with a viral illness for 4 days. He has had multiple loose bowel actions over the last few days, as well as experiencing some nausea and vomiting. He has been unable to tolerate any food since becoming unwell, and has only been able to drink some small, infrequent sips of water. His skin is pale and cool to touch, and he is agitated and drowsy. History Mr Walters has a past history of an anterior myocardial infarction, hypertension, and a recent echocardiogram confirmed a left ventricular ejection fraction of 35%. His usual medications are: bisoprolol 2.5mg daily, ramipril 5mg mane, atorvastatin 40 mg nocte, and aspirin 100 mg mane. You are the critical care nurse responsible Mr Walters’ care. Your initial assessment findings are: respiratory rate: 30 breaths per minute blood pressure: 93/57 mmHg pulse: 106 bpm (regular) SpO2: 95% on room air temperature: 37.6 degrees Celsius Glascow Coma Scale (GCS): 15 Mr Walters appears to be hypovolaemic, as evidenced by hypotension, tachycardia and tachypnoea. With specific reference to Mr Walters’ history and presentation, explain the physiological causes of his hypotension, tachycardia and tachypnoea.

Surgical Tech For Surgical Tech Pos Care

5th Edition

ISBN:9781337648868

Author:Association

Publisher:Association

Chapter13: Diagnostic Procedures

Section: Chapter Questions

Problem 2CS

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Patient R., 32 y/o, was delivered with complaints of fatigue, decrease of appetite, intensification of pigmentation in the open areas of the body, palms of the hands, cyanosis, losing weight, nausea and vomiting. The symptoms began to aggravate during 1-2 weeks after acute poisoning. Objectively: arterial pressure – 60/30 mm column of mercury, pulse – 140 beats/minute, skin turgor is lowered, the colour is dark with intense pigmentation of the elbows, scars, skin folds on the palms; clearly low levels of sodium and chlorine, high levels of potassium in the blood; glycemia – 4.3 mmol/l. What is your diagnosis?A. Addisonian crisisB. Uremic coma C. Brain comaD. Acute cardio-vascular insufficiencyE. Hypoglycemic coma
A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…
A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…
DOB: 28 Jun 1961 | GENDER: FEMALE SITUATION Mrs Donna Hovey is a 60-year-old female who was admitted to the ward two (2) days ago for pneumonia. She is now complaining of mild pressure in her chest (rated 4/10) that started 10 minutes ago while she was lying on the bed. Mrs Hovey states she also has a slight ache in the underside of her upper left arm.She is diaphoretic and feeling a little nauseated. Mrs Hovey has developed slight shortness of breath. Her peripheries are a little cool to touch BACKGROUND Mrs Hovey has a history of Ischaemic Heart Disease (IHD), hypertension and beginning Peripheral Vascular Disease (PVD). She had Coronary Artery Bypass Graft (CABG) surgery six (6) years ago with Saphenous Vein grafts to her Left Anterior Descending (LAD) coronary artery and diagonal branch. Mrs Hovey also had a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting to her Right Coronary Artery (RCA) and Posterior Descending Artery (PDA). ASSESSMENT Her…
DOB: 28 Jun 1961 | GENDER: FEMALE SITUATION Mrs Donna Hovey is a 60-year-old female who was admitted to the ward two (2) days ago for pneumonia. She is now complaining of mild pressure in her chest (rated 4/10) that started 10 minutes ago while she was lying on the bed. Mrs Hovey states she also has a slight ache in the underside of her upper left arm.She is diaphoretic and feeling a little nauseated. Mrs Hovey has developed slight shortness of breath. Her peripheries are a little cool to touch BACKGROUND Mrs Hovey has a history of Ischaemic Heart Disease (IHD), hypertension andbeginning Peripheral Vascular Disease (PVD). She had Coronary Artery Bypass Graft (CABG) surgery six (6) years ago with Saphenous Vein grafts to her Left Anterior Descending (LAD) coronary artery and diagonal branch. Mrs Hovey also had a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting to her Right Coronary Artery (RCA) and Posterior Descending Artery (PDA). ASSESSMENT Her observations at…
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DOB: 28 Jun 1961 | GENDER: FEMALE SITUATION Mrs Donna Hovey is a 60-year-old female who was admitted to the ward two (2) days ago for pneumonia. She is now complaining of mild pressure in her chest (rated 4/10) that started 10 minutes ago while she was lying on the bed. Mrs Hovey states she also has a slight ache in the underside of her upper left arm.She is diaphoretic and feeling a little nauseated. Mrs Hovey has developed slight shortness of breath. Her peripheries are a little cool to touch BACKGROUND Mrs Hovey has a history of Ischaemic Heart Disease (IHD), hypertension and beginning Peripheral Vascular Disease (PVD). She had Coronary Artery Bypass Graft (CABG) surgery six (6) years ago with Saphenous Vein grafts to her Left Anterior Descending (LAD) coronary artery and diagonal branch. Mrs Hovey also had a Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting to her Right Coronary Artery (RCA) and Posterior Descending Artery (PDA). ASSESSMENT Her…
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