Final answer:
The most pertinent question to ask the patient would be about his recent bowel movements and any previous similar episodes to assess the likelihood of hypovolemic shock due to gastrointestinal hemorrhage, and to gather information on medical history including medication use.
Step-by-step explanation:
The most pertinent question to ask a 66-year-old male presenting with dark red rectal bleeding, abdominal pain, cool and clammy skin, elevated heart rate, and a blood pressure of 112/60 mm Hg is about his recent history of bowel movements and any previous similar episodes. It is crucial to determine the duration of symptoms, any associated symptoms such as dizziness or fainting, and if there is any relevant medical history like cardiovascular disease or diverticular disease. The elevated heart rate and signs of hypovolemia, such as cool, clammy skin, suggest that he may be suffering from hypovolemic shock due to a possible gastrointestinal hemorrhage, which is supported by the presence of rectal bleeding. Loss of blood could have led to reduced blood volume and, consequently, the body's compensatory mechanism to maintain vital organ perfusion by increasing the heart rate. Understanding the patient’s full medical history, including any medication use such as anticoagulants or previous diagnoses, is crucial for managing his condition effectively.How long have you been experiencing dark red rectal bleeding?
This question is important because it helps determine the duration of the symptoms and provides insight into the possible causes of the bleeding, such as colorectal cancer or hemorrhoids.