Please assess the volume status of Mr. Kennedy, a 61 year old male, and comment on your findings.
Physical Examination
Vitals
- Assesses heart rate by palpating the radial pulse
- Measures blood pressure while supine
- Assesses orthostatic changes by measuring blood pressure and heart rate with patient standing
- Comments on vital signs findings of a patient who is hypovolemic
JVP
- Observes JVP with correct patient position (30 degrees head-up-tilt); adjusts patient accordingly if JVP is not initially evident
- Confirms JVP by changing angle of head of bed
- Occludes JVP to confirm location
- Comments on the multiple waveforms of the JVP
- Comments on the JVP height
Peripheral Vasculature
- Comments on capillary refill
- Comments on skin turgor, mottling
- Comments on mucus membranes
- Examines for peripheral edema
- Comments on peripheral temperature
Case 3 – Volume Status