Mr. Cola 75 years old tells the RPN in urgent care that he was vomiting horribly all night long and he couldn't keep anything down. What would be the nurse best initial question?

Mr. Cola 75 years old tells the RPN in urgent care that he was vomiting horribly all night long and he couldn't keep anything down. What would be the nurse best initial question?

• A. How many times and how much did you vomit?
• B. Have you had anything to eat today?
• C. Do you have a fever?
• D. Are you able to keep fluids down now?

Answer: (A)

Assessing fluid and electrolyte status quickly is the priority when vomiting has been ongoing, especially in an older adult. Asking how many times and how much he vomited provides a concrete estimate of cumulative fluid loss. This single question helps you gauge dehydration risk, plan immediate management (like IV fluids and electrolyte checks), and decide how aggressively to treat and monitor him. Other questions can be useful, but they don’t give you the immediate picture of how much fluid has been lost overnight. For example, whether he had anything to eat today or if there’s a fever adds context but doesn’t quantify the severity of dehydration. Asking if he can keep fluids down now is important, but you need the initial data on how much was lost to determine whether oral intake is feasible or if IV therapy is needed.

Assessing fluid and electrolyte status quickly is the priority when vomiting has been ongoing, especially in an older adult. Asking how many times and how much he vomited provides a concrete estimate of cumulative fluid loss. This single question helps you gauge dehydration risk, plan immediate management (like IV fluids and electrolyte checks), and decide how aggressively to treat and monitor him.

Other questions can be useful, but they don’t give you the immediate picture of how much fluid has been lost overnight. For example, whether he had anything to eat today or if there’s a fever adds context but doesn’t quantify the severity of dehydration. Asking if he can keep fluids down now is important, but you need the initial data on how much was lost to determine whether oral intake is feasible or if IV therapy is needed.