10201 - Concepts in Pathophysiology – University of Canberra

Assignment Task

Case Study 

Fluid and Electrolyte imbalance

Fluid and electrolyte imbalance You are working as a new graduate clinician in the emergency department. It’s mid-summer and temperatures over this past week have exceeded 35⁰C every day. Your emergency department has treated a number of patients for heat related illness. You have returned from your tea break to find a new patient, Dorothy, in one of your allocated bedspaces along with her daughter Mary. Mary states that she calls her mum each afternoon to discuss the day and as a welfare check. Recently, Dorothy has been reluctant to use her air conditioning due to financial pressures with increased cost of living.

Although Mary has offered to provide financial support, Dorothy is steadfast in her refusal for assistance. Mary became concerned this afternoon when her call to Dorothy went unanswered, so she drove to Dorothy’s house to check on her. Arriving at the house, Mary found her mother sitting on the floor in the kitchen dressed in her nightgown. Dorothy appeared confused, hot to touch and speaking incoherently. Concerned, Mary called an ambulance to treat her mother. Paramedics report that Dorothy was febrile (40⁰C), tachycardic (107 bpm), hypotensive (99/56mmHg) and confused on their arrival so they have transported her to hospital for further investigations and treatment.

• Tympanic temperature - 40.4⁰C
• Heart rate -121bpm
• Blood pressure-172/87 mmHg
• Respiratory rate -24 breaths/min
• AVPU - awake although confused and answering questions inappropriately
• Dry mucous membranes
• Decreased skin turgor
• Specific gravity 1.030
• Serum sodium >150mmol/L
• WCC 10.9 x109 /L
• CRP <5mg>

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