A 94-year-old woman is admitted to your hospital with dehydration, trouble breathing, and possible kidney failure. She is clearly in advanced Alzheimer's, weighs about 95 pounds, and shows multiple bruises on her body. She cannot talk. Her caregiver attributes the bruises to a blood disorder that reduces clotting. What are your thoughts about this situation? What kind of investigation would you conduct? What actions would you take to be in compliance with ethical principles?

My first thoughts would be to take detailed notes of the elderly lady’s condition and report it to the correct authorities. I do not like to jump to conclusions before understanding the situation fully; however, it is always safe to report your findings and let the proper individuals investigate the case. “In almost all states there is a duty for the health care team to protect seniors by reporting instances of suspected abuse” (Grand Canyon University, 2010). There are blood disorders that cause individuals to bruise easier than others.

Diarrhea - the most common cause of dehydration and related deaths. The large intestine absorbs water from food matter, and diarrhea prevents this from happening. The body excretes too much water, leading to dehydration.

Vomiting - leads to a loss of fluids and makes it difficult to replace water by drinking it.

Sweating - the body's cooling mechanism releases a significant amount of water. Hot and humid weather and vigorous physical activity can further increase fluid loss from sweating. Similarly, a fever can cause an increase in sweating and may dehydrate the patient, especially if there is also diarrhea and vomiting.

Diabetes - high blood sugar levels cause increased urination and fluid loss. Tips for handling summer heat for people with diabetes.

Frequent urination - usually caused by uncontrolled diabetes, but also can be due to alcohol and medications such as diuretics, antihistamines, blood pressure medications, and anti psychotics.

Burns - blood vessels can become damaged, causing fluid to leak into the surrounding tissues.