Your patient is an 88-year-old female complaining of weakness and "fuzzy thinking" after a three-day period of suspected food poisoning. Her blood pressure is 100/70, pulse 118 weak and thready, respirations 20 shallow and regular, skin pale cool and clammy. You suspect:
A. Septic shock
B. Cardiogenic shock
C. Obstructive shock
D. Hypovolemic shock
Answer (2)
Based on the symptoms provided, the most likely type of shock the patient is experiencing is hypovolemic shock. Hypovolemic shock occurs when there is a significant loss of blood or fluids in the body, leading to decreased circulating blood volume and reduced blood pressure. This can happen due to severe dehydration, which is consistent with the patient's recent three-day period of suspected food poisoning.
Here are the key points supporting this conclusion:
Weak and Thready Pulse: Indicates low blood volume or pressure, commonly seen in hypovolemia.
Low Blood Pressure (100/70): Although this blood pressure is not severely low, it is on the lower side, especially considering the patient's elevated heart rate (tachycardia).
Increased Heart Rate (Pulse 118): The heart compensates for low blood volume by pumping faster.
Pale, Cool, and Clammy Skin: These are signs of the body's compensatory mechanisms kicking in to preserve blood flow to vital organs.
History of Suspected Food Poisoning: This can lead to significant fluid loss through vomiting and/or diarrhea, contributing to hypovolemia.
Other types of shock were considered but less likely:
Septic Shock: Typically associated with fever and signs of infection, and often more profound hypotension.
Cardiogenic Shock: Usually presents with signs of heart failure, which may include chest pain or more severe hypotension.
Obstructive Shock: Generally involves a physical obstruction that affects heart function, like a pulmonary embolism or cardiac tamponade, which doesn't align with the given symptoms.
Therefore, the most appropriate choice among the given options is Hypovolemic shock .
The patient is likely experiencing hypovolemic shock due to fluid loss from suspected food poisoning. Symptoms like a weak pulse, low blood pressure, high heart rate, and cold clammy skin support this diagnosis. Hence, the chosen option is Hypovolemic shock.
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