SOLVED897

Linda Hererra, a 45-year-old businesswoman with a history of peptic ulcer disease, presents to the ED with a 10-day history of intractable vomiting and abdominal pain. She has been unable to keep solid foods down but has been drinking small amounts of water at frequent intervals. She has become progressively weaker and now complains of dizziness upon assuming an upright position. On physical examination, Ms. Hererra appears acutely ill and pale. Vital Signs (Supine) Vitals Signs (Sitting) BP 96/50 BP 72/38 HR 110 HR 140 RR 20 T 99Ù’ Physical examination is remarkable for tenting of the skin, sunken eyes, dry mucous membranes, flat jugular veins, absence of axillary sweat, and epigastric tenderness. Lab Data ABGs Hematology Na 134 pH 7.55 Hgb 17 K 2.6 pCO2 50 Hct 51 Cl 70 HCO3 40 WBC 10,000 Total CO2 41 pO2 90 Creatinine 4.5 O2 sat 95% BUN 112 Glucose 80 Urine Chemistries UA Sediment Na 15 Color Dark amber WBC 0-1/HPF K 40 pH 5.0 RBC 0-1/HPF Cl <10 Specific grav 1.024 Casts None Creatinine 200 Ketones + Crystals None Urea 2000 Protein None Osmolarity 700 Blood None A central line was placed and reveals a CVP of 2. Volume replacement SCIENCE HEALTH SCIENCE NURSING

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