This activity contains six questions. 1. An

This activity contains six questions. 1. An 84-year-old male was found at home unresponsive but breathing after vomiting large amounts of blood. He was transported by EMS to the emergency department with a massive GI bleed. Treatment by EMS en route included placement of two large-bore 16-gauge intravenous catheters, infusion of 0.9% normal saline and 100% oxygen via a nonrebreather mas k. His vital signs on admission were HR 120 regular, BP 50/30, RR 12, pulse oximetry 96%. He appeared pale and slightly diaphoretic. He has delayed capillary refill and absent peripheral pulses but still has a carotid pulse. Lungs are clear to auscultation, and his abdomen is distended. The patient has a remote history of excessive drinking, but according to his wife he has not had a drink in 25 years. Past medical history includes hypertension, depression, esophageal varices, cirrhosis, question of esophageal cancer, and abdominal aortic aneurysm repair years ago. On admission, labs revealed . Sodium 150 Potassium 3.9 BUN 30 Hemoglobin 5.6, Hematocrit 25 INR 2.28 PT 22 PTT 35 1. What signs and symptoms indicate hypovolemia in this patient? 2. What lab tests indicate hypovolemia? 3. Explain the relationship between the patient’s hypotension, tachycardia, and peripheral vasoconstriction. 4. The patient’s pulse oximetry is 96%. Further evaluate the saturation, considering his hemoglobin is 5.6. 5. What are immediate priorities in the collaborative management of this patient? 6. How would a nurse recognize that a hypovolemic patient had received adequate volume replacement?

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