Anna Zemakis is a 49-year-old woman admitted to the hospital with severe vomiting and muscle weakness. She fell 2 weeks ago and reports not feeling well since. Four days ago, she developed abdominal discomfort with vomiting. The vomiting has been severe, and she has not been able to eat or drink very much. She says she has lost a significant amount of weight. She has felt very weak, anorexic, and lethargic. She has not had diarrhea or urinary symptoms. There is no significant past medical history, and she reports she is not on any prescribed medications or taking anything over-the-counter. Ms. Zemakis's vital signs are as follows: TO 37.7C (98.9F): HR 84 bpm; R 18/min; BP 90/58 mmHg (sitting), BP 110/60 mmHg (lying); pulse oximetry 98% on room air. Her lungs are clear, and her heart sounds normal. You observe she has dry mucous membranes. Initial examination reveals slight abdominal tenderness. Clinical Reasoning Questions Level Question

1. What is Ms. Zemakis's primary health problem?

2. As the nurse assigned to Ms. Zemakis, what are your concerns at this time? Clinical Reasoning Questions Level II

3. What nursing diagnoses are appropriate for Ms. Zemakis at this time? Which takes priority?

4. What therapies would assist Ms. Zemakis in returning to homeostasis?

5. Referring to the module on Perfusion: What is the significance of the different blood pressure readings in different positions?