A 78-year-old woman is brought to the clinic by her son, who reports that she has had three days of diarrhea that is now watery with small amounts of blood, and periodic vomiting occurring once or twice daily. The woman appears weak and ill. Her son reports that the woman lives with him, and that his family and children have recently been sick with gastroenteritis. The patient’s mucous membranes appear dry, and she reports feeling dizzy and falling earlier in the day. The fall resulted in bruising on her hip and elbow but no other apparent injuries. The patient takes antihypertensive medication, an oral antidiabetic medication, and occasional ibuprofen for joint pain; she is otherwise healthy. The patient’s vital signs are temperature 99.8°F, heart rate 96, respiratory rate 24, and blood pressure 118/58.
Case Questions:
What additional assessment information should be obtained?
What are the differential diagnoses for this patient?
What management will be recommended for the patient?
What patient education should be included?
