It is likely that Jean’s hypotension was caused by dehydration and Jean tells the Doctor that she has not had anything to drink for about 12 hours having had a swallow assessment completed shortly after admission to hospital. The Scottish stroke care standards stipulate that swallowing ability must be assessed within 4 hours of admission to hospital.
What should you do next? Select yes or no for each of the questions below.
What should you do next?
1. Give Jean a cup of tea – No – oral fluid of this type is insufficient to rehydrate the patient effectively.
NB: As per Scottish stroke care standards Jeans swallowing ability was assessed within 4 hours of admission to hospital. There we concerns regarding her swallowing safely so she had not received any oral fluids since her admission to the hospital. For more information on swallow screen assessment see Case 3: Archie swallow screening test
2. Ensure IV access – Yes – this is important to rehydrate effectively. The urea was high, the sodium was high and the creatinine was increased in keeping with dehydration.
3. Start IV fluids – Yes – IV fluids are commonly used for rehydration e.g. normal saline. The urea was high, the sodium was high and the creatinine was increased in keeping with dehydration.
4. Give Jean blood – No – Hb is 15, there are no signs of bleeding, so blood not indicated. A normal INR of 1.1 shows patient is not anticoagulated.
5. Just continue monitoring Jean – No – this alone is not sufficient -the patient requires active rehydration intervention.
Page last reviewed: 14 Oct 2020
