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 n vomiting dark coffee ground emesis for about an hour. His blood pressure is 90/40, pulse 100, and respiratory rate of 24. Aside from the airway, what is your greatest concern?

A. The patient will become combative.
B. The patient will have a stroke.
C. The patient will have a myocardial infarction.
D. The patient will go into hypovolemic shock.

Answer 1

The patient exhibiting abdominal pain, coffee ground emesis, and low blood pressure is at significant risk of hypovolemic shock due to potential gastrointestinal bleeding.

Step-by-step explanation:

The greatest concern for an 85-year-old patient with abdominal pain, a history of dementia, and vomiting dark coffee ground emesis is the risk of hypovolemic shock. Given his vital signs, with a blood pressure of 90/40, pulse of 100, and respiratory rate of 24, these symptoms suggest that the patient is experiencing significant blood loss, leading to low blood volume and potential circulatory collapse. The coffee ground emesis indicates possible gastrointestinal bleeding, which can result in rapid fluid loss and escalation to shock if not treated promptly. Appropriate medical interventions, including fluid resuscitation and potential transfusions, are crucial to managing this patient's condition.