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The essay will examine a 77 year old women named Maureen Hardy, who hasexperienced haematemesis twice at home and again started vomiting blood when brought toward. The particular essay includes sign and symptoms related to the hypovolemia along withthe pathophysiology of the problem.Water makes up around 90% of the whole blood (Van Regenmortel, Jorens & Malbrain,2014). In case when body becomes dehydrated due to inadequate intake of fluids, then it tries tomaintain its cardiac output by increasing the heart rate which results in more blood beingpumped. But with fluid loss, whole functioning of body fails that results into hypovolaemicshock.Hypovolemia is defined as the decrease in volume of blood that circulates in the body(Stricker & Jalowiec, 2017). Hypovolemic shock, is a life-threatening state in which the bodyloses more than 20% of whole body fluid (Abdulrahman, Shabkah, Hassanain & Aljiffry, 2014).Common sign and symptoms that tend to appear during hypovolemia are: pale and moist skin,lowers the rates of urination, general weakness, increased breathing rate along with sweating,state of unconsciousness, cool and clammy skin, anxiety and state of confusion (Zengin et.al.,2013).In situation when a person is suffering from Hypovolemia, several systems of bodygenerate response against it: haematologic, renal, neuroendocrine and cardiovascular system.Haematologic system responds to acute blood loss by activation of coagulation process causingconstriction of blood vessels (Ieva et.al., 2013). Cardiovascular system helps by pumping bloodthrough heart at faster rate which distributes the blood to major organs like lungs, brain andheart. Neuronal system and endocrine system aids by reabsorbing the sodium and water. When such cases are brought to hospitals, the first step is to identify the sign andsymptoms then prioritise them with ABCDE approach. A refers to airway examination with thepractitioner looking for sign regarding airways obstruction (Kocsi et.al., 2013). It includeslistening to noises that arises while breathing and observing movement of chest and abdominalmuscles (Siebenmann et.al., 2013). In the case of Maureen she was having equal bilateral chestmoment and her depth of each breath was normal. This indicates that her airways was clear andno treatment regarding trachea was required (Liamis, Filippatos & Elisaf, 2015). 1
The second step of ABCDE approach refers to the breathing examination. In this type ofassessment doctors look for common sign for respiratory disorder like dyspnea, tachypnea andabdominal breathing (Holder, Clermont & Pinsky, 2014). It also includes examining respiratoryrate, SaO2 reading, listening to breathing sound and examining the chest disorders (Phillip &Runyon, 2014). The breathing rate found in Maureen was 28 breaths per minute. This indicates thatMaureen was in the third stage of Hypovolemia, in this stage the breathing rate are above 20 andbelow 30 breaths per minutes (Siebenmann et.al., 2013). It is also found that SaO2 is notreadable and it is necessary to identify to check the amount of oxygen content in blood (Zenginet.al., 2013). Next step regarding ABCDE approach is Circulation examination. According to thisexamination, nurses will look at the colour of hand and face, temperature of body, they alsomeasure the capillary return time, check patient pulse rate and blood pressure and examine thepatient'swhole body for any sign of haemorrhage and signs related to cardiac output (Vaughan &Parry, 2016). In case of Maureen the blood pressure found was 80 mm Hg systolic, that indicatesthe third stage of hypovolemia shock and needs an urgent treatment. The capillary refill time wasfound less than 4 seconds which indicate the sign of dehydration and shock. The x-ray reports ofMaureen chest were normal no any disorder was found. Her temperature of 36.5 was found to benormal. Dehydration is the main reason that she was looking sweaty and drowsy (Schulenkorf &Spaaij, 2015). The Haemoglobin test of Maureen provided a reading of 9 g/dl, this indicates thatshe is prone to anaemia and has lack of red blood cells in blood. Maureen was continuouslyvomiting and her face was looking pale due to the loss of blood in her vomits. Haematocrit levelwas 27% which also support the anaemic condition she has. These conditions needed to beresolved early to reduce her other life-threatening risk. In case of Maureen according to her ECG report, it was found that she was experiencingSinus tachycardia which indicates a heart rate greater than 100 beats per minute (Stricker &Jalowiec, 2017). It was found that her heart rate was 120 beats per minute and was irregular, thisis because of the compensation of cardiovascular system (Hoiseth et.al., 2015). In case ofhypovolemia, the heart pumps more rapidly to distribute the blood to major organs including thelungs, brain and heart. This resulted in the increased heart rate in Maureen. 2
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