An 87-year female, with a 3-day history of intermittent abdominal pain, abdominal bloating, and nausea and vomiting, came to the emergency department. She moved from Puerto Rico to join her grandson and his family only 2 months ago and speaks very little English. All information was obtained through her grandson. PMH includes an abdominal hysterectomy 12 years ago and an inguinal hernia repair 2- years ago. She has nod history of coronary artery disease, diabetes or pulmonary disease. She takes only ibuprofen occasionally for mild arthritis. She has no known drug allergies (NKDA). Vital signs are: Blood Pressure 134/84, Pulse 84 beats/minute and regular, Respirations 20/minute and Temperature 97.2º F (36.2 ºC). An IV of D5 ½ NS with 20 mEq KCl at 100 mL/hour is started Nasal O2 at 2 L is also ordered. With some difficulty a nasogastric tube (NGT) is inserted and connected to intermittent low wall suction. The NGT suddenly drains 575 mL and then slows to about 190 mL every hour.
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