A 3-Year-Old Boy Is Brought to the Emergency Department Due

question 65

Multiple Choice

A 3-year-old boy is brought to the emergency department due to a fever and stiff neck.  The child is hospitalized with a diagnosis of bacterial meningitis and begins treatment with intravenous antibiotics.  On day 2 of hospitalization, the mother requests to take the child home and explains that she intends to treat him with homeopathic remedies.  She has 4 other children at home who have "never needed vaccinations or medications" and are "strong and healthy."  The physician explains the risks of meningitis, including brain damage and death.  After a long discussion, the mother says that she understands the risks but believes that homeopathic remedies will be adequate for treatment and remains unconvinced of the need for hospitalization.  Which of the following is the most appropriate course of action?

• A)Arrange for a psychiatric evaluation to assess the mother's decision-making capacity
• B)Arrange for a visiting nurse to administer intravenous antibiotics at home
• C)Contact child protective services while continuing intravenous antibiotics
• D)Discharge against medical advice with instructions to return if the child's condition deteriorates
• E)Discharge the patient on oral antibiotics with daily in-home check ups

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Definitions:

Brain Surgery

A medical procedure involving the treatment or removal of disorders within the brain through an operative approach.

Obsessive-Compulsive Disorder

A mental disorder characterized by repetitive, unwanted thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions).

Cognitive

Pertaining to mental processes such as perception, memory, judgment, and reasoning, as opposed to emotional or physical processes.

Automatic Thoughts

Unconscious, spontaneous thoughts that can influence emotions and behavior, often occurring as a response to particular situations.