Ms. D, a 54-year-old patient, is brought to the emergency department by her daughter because of weakness and a decreasing level of consciousness. The daughter says that Ms. D has been reporting nausea, with associated abdominal and back pain. Although usually Ms. D is very alert and oriented, today she has been increasingly lethargic. Her medical history includes hypertension, atrial fibrillation, and diabetes mellitus type 2. The initial vital sign values are as follows: Blood pressure 102/38 mm Hg Heart rate 102 beats/min O2 saturation 76% (0.76) Respiratory rate 30 breaths/min Temperature 102.4° F (39.1° C) CASE STUDY QUESTION