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Mr Lance Joy is 67 year old and has been admitted for fluid replacement therapy for dehydration following a severe bout of vomiting and diarrhoea. Mr Joy's medical background is HT, AF, and CVD. He has been commenced on IV therapy and was given a bolus of 500ml of Hartman's Solution in Emergency after being brought in by Ambulance following a conscious collapse. He currently has Hartman running at a rate of 250 ml per hour to maintain hydratian. The infusion is gravity fed and appears to be running much faster than required as the bag has only 150mL remaining and has only been running for 1 hour. After settling him in the room he appears short of breath. You leave the room to collect the observation machine to take his observations. On returning his shortness of breath has become worse, he looks distressed, his lips look a bit blue, and he is very restless and anxious and trying to get off the bed. Vital signs: BP 154/67, HR 128, R36, Sa02 89% in room air, T 37.8, and GCS 13. He is alert but disoriented. Record and evaluate fluid and electrolyte imbalances, and monitor the effect on the person with IV fluids? Report to CERT (Clinical Emergency Response Team) and evaluate fluid and electrolyte imbalances? Complete ISBAR format for your communication and documentation.
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