Final answer:
Confusion, due to its impact on patient safety and possibility of being an acute change, should be the first symptom assessed in an older adult with hypervolemia. A patient with a blood pressure of 70/45 mmHg, confusion, and thirst is likely suffering from decreased blood pressure, which can lead to reduced tissue perfusion and cognitive symptoms.
Step-by-step explanation:
A patient with hypervolemia may be exhibiting various symptoms, including increased blood pressure, dependent edema, confusion, and elevated central venous pressure (CVP).
When prioritizing care for an older adult, confusion should often be assessed first because it can be an acute change in mental status indicating an imbalance, and it may lead to safety concerns. Dependent edema is also a significant sign but may develop more slowly than changes in cognitive status.
Furthermore, a patient with a blood pressure of 70/45 mmHg, confusion, and thirst is likely experiencing decreased blood pressure. This low blood pressure can lead to inadequate tissue perfusion, including to the brain, which may result in confusion and a compensatory increase in thirst due to the body's attempt to restore volume status.
In case of such a medical emergency, professionals would likely administer isotonic saline to match the tonicity of body fluids and help restore proper fluid balance without causing additional cellular imbalance.