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a thesis and an outline on Clinical Examination of Mr Robinson

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a thesis and an outline on Clinical Examination of Mr Robinson. Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required. 1. Mr Robinson presented to the Emergency unit after vomiting a massive amount of blood. His current status represents a state of hypovolemic shock which was caused by a large amount of blood in his vomit.

Mild to moderate hypovolemia only leads to resting tachycardia, however blood loss of at least 50 per cent results in supine hypotension (Saltzman & Fieldman 2013). The loss of blood leads to reduced intravascular volume and inadequate tissue perfusion. This causes a reduced arterial pressure and decreased tissue perfusion. hence the tissues are deprived of oxygen and nutrients (Lippincott Williams & Wilkins 2009). Mr Robinson presented with increased blood urea nitrogen suggesting renal failure due to “a large quantity of blood” in his vomiting, pointing out towards the massive reduction in intravascular volume leading to hypovolemia.

Mr. Robinson’s initial presentation is consistent with the signs of hypovolemic shock and presented to the Emergency room with cold and clammy skin, tachycardia and anxiousness. His pulse was 130 beats per minute which were weak and thread in nature, exhibiting hypovolemia. As a compensatory effect, the respiratory rate is increased leading to hyperventilation, in an attempt to increase the partial pressure of oxygen in arterial blood. Mr. Robinson’s respiratory rate was 36 breaths per minute, suggesting that he was hyperventilating as a compensatory response to the metabolic acidosis.

&nbsp.Acute upper gastrointestinal bleeding can present either as blood in vomiting (hematemesis) or melena (blood in stool). In the given case, the patient presents with massive upper GI blood loss through vomiting which leads to a medically critical state of hypovolemia. Approach to diagnosis of a medical case first revolves around the history of the patient.