Question

You are called to a nursing home for an​ 85-year-old patient complaining of abdominal pain. the patient has a history of dementia and cannot describe the pain to you. the nurse states the patient has been vomiting dark coffee ground emesis for about an hour. his blood pressure is​ 90/40, pulse​ 100, and respiratory rate of 24. auscultating this​ patient's bowel​ sounds:

Answer 1

A patient with dementia in a nursing home presents with signs suggestive of an upper gastrointestinal bleed, indicated by coffee ground emesis and vital sign abnormalities consistent with potential hypovolemic shock.

Step-by-step explanation:

When called to a nursing home for an 85-year-old patient with abdominal pain and a history of dementia who cannot adequately describe the pain, and a nurse reports the patient has been vomiting dark coffee ground emesis for about an hour, it is critical to assess vital signs which show hypotension (blood pressure of 90/40), tachycardia (pulse of 100), and tachypnea (respiratory rate of 24). These symptoms suggest the patient might be experiencing an upper gastrointestinal bleed, which is corroborated by the characteristic coffee ground emesis—a sign of digested blood. Auscultating this patient's bowels could reveal hypoactive bowel sounds due to the probable internal bleeding. The low blood pressure, increased heart rate, and respiratory rate point to potential hypovolemic shock as the patient's cardiovascular system attempts to compensate for the decreased volume. Immediate medical assessment and intervention, such as IV fluid resuscitation and potentially blood transfusions, are necessary to stabilize the patient and manage the underlying condition.

Answer 2

The patient will go into hypovolemic shock.

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