Soon2BSN

I am working on my concept map/care plan for my critical care rotation. My patient has a history of MI and Diabetes. On the day i cared for this patient they had an active GI Bleed and Afib. I established that i would make 1. Risk for Fluid Volume Deficit r/t I chose this as my number 1 priority because on the day i cared for this pt. they were actively bleeding. I would have chosen Cardiac as my number one had this not been the case. Also, the albumin was 2.2 i wonder if there was third spacing exacerbating this due to being NPO for an extended period of time. My evidence for this is Poor pulses - +1 Edema - +2 Cool extremities Clammy Skin Mottling Cap refil Vfib Confusion/icuitis Perrla Decreased bowel sounds - possibly not enough blood flow reaching the gut? Nausea - zofran on med list Distention/pain - again possibly not enough bloow flow to gut? This patients vital signs proved - Tachycardia, tachypnea, and hypotension. Labs: CR high, no ABGS or BUN available. Albumin 2.2 Meds: Zofran, lasix, digoxin Input: NPO 1000ml/day NS Output: 2. Decreased Cardiac Ouput r/t decreased ventricular filling, altered afterload, impaired contractitlity, altered rate and rhythm, increased o2 demand, and cardiac disease. 3. Poor Tissue Perfusion r/t hypovolemia, myocardial ischemia, low hemoglobin, and reduced arterial blood flow. This patient had visible PAD "cowboy boots", edema 2+ in lower extremities. Do i seem to be headed in the right direction?