Case Study: An 85-year-old female with a

Case Study: An 85-year-old female with a history of Alzheimer’s dementia and Hypertension presents to the emergency room via ambulance from a nursing home. The report from the nursing home staff is that the patient developed a change in mental status. The ambulance team reports that on their arrival, the patient’s blood pressure was 80/40mmHg. Her medications at the nursing home include Aricept, Hydrochlorothiazide, and Metoprolol. Objective/ PE General: The patient is lying quietly in bed. She is somewhat difficult to arouse with sternal rub. VSS: Her pulse is 120 beats/min, BP is 80/40, RR is 18, and temperature is 101 degrees Fahrenheit. Cardiac: S1S2 NSR no rubs, bruits, or murmurs Resp: Lung sounds are clear to auscultation ABD: Some mild to moderate suprapubic tenderness but is otherwise normal The rest of her physical examination is normal A Foley catheter is in place and contains dark-colored urine with small amounts of pus Laboratory findings: Urinalysis shows many bacteria with >100 WBC/hpf and positive nitrite. WBC 15,000 DIFFERENTIAL Seg Neutrophils 76 Lymphocytes 12 Monocytes 5 Eosinophils 4 Basophils 2 Bands 1 Hgb 15 HCT 45.5 MCV 89.2 MCHC 34 Questions: What additional history would you like from the nursing home staff, patient’s chart, and ambulance team? Based on the history and physical examination, what is your Differential Diagnosis and which diagnosis would you consider most likely in this patient? Define shock. What are the main categories of shock? How would you continue to manage this patient? SCIENCE HEALTH SCIENCE NURSING MEDICAL 145

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."