Regarding the fluid volume balance, some findings suggest the presence of hypovolemic status. As for physical assessment, relevant findings to support this conclusion include mucous membrane dryness and decreased blood pressure (Taghavi & Askari, 2020). Increases in heart rate, poor skin turgor, and confusion also support this suggestion (Taghavi & Askari, 2020). Next, relevant lab results include elevated BUN levels (Taghavi & Askari, 2020). In terms of electrolyte status, multiple signs of electrolyte imbalance (physical: heartbeat irregularities, elevated heart rate, mental confusion; lab: relatively low blood potassium, low levels of chloride) can be found. As for etiology, the man’s condition is probably linked to the chronic use of diuretics or a history of CHF.
In the patient’s case, there are ECG changes to consider. Sinus tachycardia is commonly observed in hypovolemic patients (Taghavi & Askari, 2020). In this case, it is manifested because of increases in the patient’s heart rate. In its turn, a rapid heartbeat is likely to be the body’s normal response to stressors and attempts to increase the delivery of oxygen.
The patient’s blood pH levels lightly exceed the normal range, and the same is true for PaCO2, which might point to respiratory acidosis. HCO3 levels are also elevated, which involves the possibility of metabolic alkalosis. The patient’s pH is not normal, which might be indicative of the body’s attempts to compensate for the ongoing imbalance.
The patient’s age contributes to his risks of fluid imbalance. Among the age-related changes that can increase a person’s predisposition to this health issue are natural decreases in total body water and diverse changes affecting renal function (Shah & Lewis, 2018). Other possible reasons include the use of different medications (the need for medications often increases with age) and age-related mental health declines that can affect people’s self-care practices.
Aldosterone plays one of the key roles in helping the body to maintain water and electrolyte balance by having a direct impact on the absorption of sodium and the excretion of potassium (Scott et al., 2020). In the kidneys, it supports the reabsorption of sodium and water into the bloodstream, which leads to the normalization of blood pressure and salt levels (Scott et al., 2020). Therefore, changes in aldosterone could help to alleviate the patient’s imbalances.
References
Scott, J. H., Menouar, M. A., & Dunn, R. J. (2020). Physiology, aldosterone. StatPearls Publishing. Web.
Shah, S., & Lewis, M. C. (2018). Renal, metabolic, and endocrine aging. In J. G. Reves, S. R. Barnett, J. R. McSwain, & G. A. Rooke (Eds.), Geriatric anaesthesiology (3rd ed.) (pp. 197-202). Springer International Publishing.
Taghavi, S., & Askari, R. (2020). Hypovolemic shock. StatPearls Publishing. Web.