Case-3: Patient History T.J. is a 46-year-old science professor brought to urgen
ID: 90454 • Letter: C
Question
Case-3: Patient History
T.J. is a 46-year-old science professor brought to urgent care this afternoon by his wife. T.J. has been at home for 3 days with severe diarrhea and vomiting. His youngest daughter was hospitalized earlier in the week with similar symptoms. T.J. has no significant medical history and takes no medications. Examination reveals an ill-appearing, pale, diaphoretic man who is having difficulty concentrating and answering questions. He has diffuse abdominal pain. Vital signs are as follows: Lying—HR 100, BP 100/80, resp 26, temp 100. Sitting—HR 136, BP 90/60. He has not urinated since yesterday morning.
Analyze this case study and answer the next three questions that follow.
Case-3: Question-1
What other laboratory or clinical data would be helpful in assessing T.J.’s fluid-electrolyte and acid-base status? (select all that apply)
Case-3: Question-2
Which assessment data should be monitored during fluid replacement therapy to determine when adequate volume has been restored? (select all that apply)
Case-3: Question-3
How might persistent vomiting and diarrhea alter acid-base balance? (select all that apply)
Blood test to assess the level of glucose.Explanation / Answer
ans1 A chemistry panel would be helpful in assessing for imbalances of serum sodium, potassium, and bicarbonate.
Reason-Due to the persistent diarrhea and vomiting there's significant imbalance of electrolytes which include Na,K,and bicarbonate and also glucose level in the body.The assesment of body fluids and its regulation levels chemistry is prior important to conclude the condition, because to maintain body homeostatis the body fluids plays an vital role
Due increase or decrease the levels of these electrolytes may distrubs the balance of the body condition dehydration cause the skin turgor-tenting, reduced urine output, dry mucous membrane ,orthostatic hypotension,irritated/lethargic mental status.
ans-2 Electrolytes should be monitored for resolution of any electrolyte imbalance
Skin turgor and mucous membranes should be monitored for improvement of dehydration.
reason - for assessment of restoration of fluids orientation of patient (IV fluid shoud be hypotonic because pure water would lyse RBC's ) and mental state analysedin every two hours,vital are checked,skin pinch test done to analyse the state of dehydration of patient during the pathological condition
ans-3 Vomiting may contribute to metabolic alkalosis.
Metabolic acidosis may occur as a result of persistent diarrhea.
reason-Vomiting cause the excess removel of the H ion from the body cause elevated bicarbonate ion due to alkalosis