Case-3: Patient History
T.J. is a 46-year-old science professor brought to urgent care this afternoon by his wife. T.J. has been at home for 3 days with severe diarrhea and vomiting. His youngest daughter was hospitalized earlier in the week with similar symptoms. T.J. has no significant medical history and takes no medications. Examination reveals an ill-appearing, pale, diaphoretic man who is having difficulty concentrating and answering questions. He has diffuse abdominal pain. Vital signs are as follows: LyingâHR 100, BP 100/80, resp 26, temp 100. SittingâHR 136, BP 90/60. He has not urinated since yesterday morning.
Analyze this case study and answer the next three questions that follow.
Case-3: Question-1
What other laboratory or clinical data would be helpful in assessing T.J.âs fluid-electrolyte and acid-base status? (select all that apply)
Blood test to assess the level of glucose.
A chemistry panel would be helpful in assessing for imbalances of serum sodium, potassium, and bicarbonate.
Further assessment could include inspection of mucous membranes for dryness, skin turgor, status of neck veins, and presence of dizziness with position change.
Assessment of body temperature.
Case-3: Question-2
Which assessment data should be monitored during fluid replacement therapy to determine when adequate volume has been restored? (select all that apply)
Mental status should be assessed and expected to improve with adequate fluid replacement.
Vital signs should be monitored for resolution of tachycardia and postural symptoms, as well as intake and output.
Skin turgor and mucous membranes should be monitored for improvement of dehydration.
Electrolytes should be monitored for resolution of any electrolyte imbalance.
Case-3: Question-3
How might persistent vomiting and diarrhea alter acid-base balance? (select all that apply)
Metabolic alkalosis may occur as a result of persistent diarrhea.
Vomiting may contribute to metabolic acidosis.
Metabolic acidosis may occur as a result of persistent diarrhea.
Vomiting may contribute to metabolic alkalosis.
Case-3: Patient History
T.J. is a 46-year-old science professor brought to urgent care this afternoon by his wife. T.J. has been at home for 3 days with severe diarrhea and vomiting. His youngest daughter was hospitalized earlier in the week with similar symptoms. T.J. has no significant medical history and takes no medications. Examination reveals an ill-appearing, pale, diaphoretic man who is having difficulty concentrating and answering questions. He has diffuse abdominal pain. Vital signs are as follows: LyingâHR 100, BP 100/80, resp 26, temp 100. SittingâHR 136, BP 90/60. He has not urinated since yesterday morning.
Analyze this case study and answer the next three questions that follow.
Case-3: Question-1
What other laboratory or clinical data would be helpful in assessing T.J.âs fluid-electrolyte and acid-base status? (select all that apply)
| Blood test to assess the level of glucose. |
| A chemistry panel would be helpful in assessing for imbalances of serum sodium, potassium, and bicarbonate. |
| Further assessment could include inspection of mucous membranes for dryness, skin turgor, status of neck veins, and presence of dizziness with position change. |
| Assessment of body temperature. |
Case-3: Question-2
Which assessment data should be monitored during fluid replacement therapy to determine when adequate volume has been restored? (select all that apply)
| Mental status should be assessed and expected to improve with adequate fluid replacement. |
| Vital signs should be monitored for resolution of tachycardia and postural symptoms, as well as intake and output. |
| Skin turgor and mucous membranes should be monitored for improvement of dehydration. |
| Electrolytes should be monitored for resolution of any electrolyte imbalance. |
Case-3: Question-3
How might persistent vomiting and diarrhea alter acid-base balance? (select all that apply)
| Metabolic alkalosis may occur as a result of persistent diarrhea. |
| Vomiting may contribute to metabolic acidosis. |
| Metabolic acidosis may occur as a result of persistent diarrhea. |
| Vomiting may contribute to metabolic alkalosis. |
