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.
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