1. Mrs. Jingle, 90-year-old, brought to Emergency Dept. by paramedics with a full code status lives in a Board & Care Facility that provides meals/medications. She's had flu symptoms for 2 days: nausea, vomiting, diarrhea;anorexia. Vital Signs: 92/60 mm Hg, Heart Rate (HR) 115 beats/min., Respiratory Rate (RR) 24/ min., SpO2 90% on room air, Temp PO 102.4°F/39.11°C. Medication HX: Lasix /Furosemide 20 mg PO daily;Lanoxin/Digoxin .25 mg PO daily; Lopressor/ Metoprolol 12.5 mg PO BID. Telemetry monitor shows Sinus Tachycardia. Admitted to ICU with a Mean Arterial Pressure (MAP) of 50 mm Hg. 1) The RN immediately identifies Mrs. Jingle's presenting problem as: A) Increased afterload B) Increased preload C) Decreased preload D) Decreased afterload ● Mrs. Jingle has dehydration → hypovolemia → shock ● caused by N,V, Diarrhea, temp of 102.4F potentially exacerbated by Furosemide (diuretic) ● Clinical manifestations = decreased preload, sinus tach, fever, MAP <60>

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