Question

Your patient is a 56 y/o woman with ah history of T2DM who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure is 80/60mmHg. The cardiac monitor documents the rhythm shown here. She is receiving oxygen at 4 L/min by nasal cannula, and an IV has been established. What do you administer next?

Answer 1

The patient likely requires the administration of intravenous fluids to address her symptoms of shock and low blood pressure. Further treatment should be guided by her response to fluids and ongoing assessment, with considerations for her T2DM history.

Step-by-step explanation:

The patient, a 56-year-old woman with a history of Type 2 Diabetes Mellitus (T2DM), presenting with dizziness, pallor, diaphoresis, and a blood pressure of 80/60 mmHg may be experiencing hypovolemic shock, possibly due to severe dehydration or less likely, bleeding. Given the vital signs and symptoms, administration of intravenous fluids is a key step in the initial management to increase intravascular volume and improve blood pressure and perfusion.

Given the low blood pressure and cardiac monitoring data (which is not provided here but critical in the actual scenario), vasoconstrictors or inotropes may also be considered if the patient does not adequately respond to fluid resuscitation. As she is on oxygen therapy and has established IV access, closely monitor her response to the treatment and be prepared to administer medications like insulin if a hyperglycemic crisis is also present, as the history of T2DM might suggest. It is essential to continuously reassess vital signs, cardiac rhythm, and clinical status.