Lorenzo Russo Year Explained for Students (Easy Guide)
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Original Question
Lorenzo Russo is a 68-year-old male of Italian heritage and was admitted to our ward at 2:45 hrs. he has a 2-day history of vomiting and diarrhea related to food poisoning. He has a history of type 2 diabetes mellitus. He smokes, increased bmi and has hypertension. His ivc tissued (phlebitis) overnight and the staff have been unable to resite it as his veins were difficult to cannulate and the Registered medical officer (rmo) has been busy with a deteriorating patient. He has not received iv hydration since 0100 hrs. his last urine output, at 2345 hours, was 70mls and it was concentrated/dark in colour ( dehydrated). A bladder scan was done at 0500 hours and showed no residual urine. His last episode of vomiting and diarrhea was 0515 hours. He has dry mucous membranes, poor skin turgor and cool peripheries indicating dehydration, the morning RMO orders UECr blood tests and is preparing to re-cannulate for stat iv bolus of normal saline (0.9% NaCI). It is nor 0735 hours. His recent vital signs at 0730 hours are: BP 90/60 mmHg HR 115 bpm RR 18 breaths per minute SpO2 94% Room Air via finger probe and his SpO2 has consistently been 94-96% since admission T 36.6 Based on your initial impression, other than dehydration, what do you think is NOW happening with Lorenzo? In your answer please provide relevant pathophysiology. What clinical impression, together with signs and symptoms, is Lorenzo presenting with that formed your impression of the condition you believe he is now suffering from and why do these signs & symptoms occur (the underlying pathophysiology)? Discuss the nursing care and management, using evidence-based literature, required for managing and maintaining Lorenzo’s potential diagnosis (what do you think is now happening), in a culturally safe manner, with rationales as to why this care is provided. Include relevant medical and pharmacological treatment options. List two ACUTE potential problems that Lorenzo is at risk of due to this current condition that you think is occurring. Provide rationales as to why these are potential risks and three nursing management preventative strategies for each of these problems – IS IT DEHYDRATION, ACUTE KIDNEY FALIURE?
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