A Patient Who Reports an Intestinal Fistula Also Reports Feeling

Multiple Choice

A patient who reports an intestinal fistula also reports feeling "weak and dizzy" when she stands.While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position.What nursing interventions will the nurse implement before calling the physician?

A) Sit her up again, with proper support, so you can have an accurate upright blood pressure and heart rate to report.
B) Give her a drink of water or juice, talk with her to calm her down, and ask if she slept well last night.
C) Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.
D) Assess small vein filling time, look for ankle edema, and ask if she had any fluid to drink yet today.