Examlex

Solved

A 20-Year-Old African American Woman with Sickle Cell Disease Comes

question 95

Multiple Choice

A 20-year-old African American woman with sickle cell disease comes to the emergency department with complaints of severe generalized body pain for 1 day.  She has been hospitalized for similar episodes in the past.  Her medications include folic acid, hydroxyurea, and hydrocodone as needed for pain.
After initial evaluation, including pertinent laboratory studies and chest x-ray, she is started on 1/2 normal saline at 125 mL/hr and hydromorphone every 3 hours.  Over the next 36 hours, the patient complains of worsening chest pain and mild shortness of breath.  Her temperature is 38.9 C (102 F) , pulse is 112/min, and respirations are 23/min.  Oxygen saturation is 93% on 2 L O2.  Lung examination shows bilateral crackles.  Lower-extremity examination shows tenderness with palpation.
Laboratory results are as follows:
A 20-year-old African American woman with sickle cell disease comes to the emergency department with complaints of severe generalized body pain for 1 day.  She has been hospitalized for similar episodes in the past.  Her medications include folic acid, hydroxyurea, and hydrocodone as needed for pain. After initial evaluation, including pertinent laboratory studies and chest x-ray, she is started on 1/2 normal saline at 125 mL/hr and hydromorphone every 3 hours.  Over the next 36 hours, the patient complains of worsening chest pain and mild shortness of breath.  Her temperature is 38.9 C (102 F) , pulse is 112/min, and respirations are 23/min.  Oxygen saturation is 93% on 2 L O<sub>2</sub>.  Lung examination shows bilateral crackles.  Lower-extremity examination shows tenderness with palpation. Laboratory results are as follows: She has good urine output.  Her chest x-ray on admission (Image 1) and repeat x-ray after 36 hours (Image 2) are shown below. Which of the following, if instituted on initial presentation, may have helped prevent the clinical worsening that occurred in this patient? A) Antibiotic prophylaxis B) Hydromorphone PCA pump C) Incentive spirometry D) Inhaled bronchodilators E) Stringent use of intravenous hydration
She has good urine output.  Her chest x-ray on admission (Image 1) and repeat x-ray after 36 hours (Image 2) are shown below.
A 20-year-old African American woman with sickle cell disease comes to the emergency department with complaints of severe generalized body pain for 1 day.  She has been hospitalized for similar episodes in the past.  Her medications include folic acid, hydroxyurea, and hydrocodone as needed for pain. After initial evaluation, including pertinent laboratory studies and chest x-ray, she is started on 1/2 normal saline at 125 mL/hr and hydromorphone every 3 hours.  Over the next 36 hours, the patient complains of worsening chest pain and mild shortness of breath.  Her temperature is 38.9 C (102 F) , pulse is 112/min, and respirations are 23/min.  Oxygen saturation is 93% on 2 L O<sub>2</sub>.  Lung examination shows bilateral crackles.  Lower-extremity examination shows tenderness with palpation. Laboratory results are as follows: She has good urine output.  Her chest x-ray on admission (Image 1) and repeat x-ray after 36 hours (Image 2) are shown below. Which of the following, if instituted on initial presentation, may have helped prevent the clinical worsening that occurred in this patient? A) Antibiotic prophylaxis B) Hydromorphone PCA pump C) Incentive spirometry D) Inhaled bronchodilators E) Stringent use of intravenous hydration
A 20-year-old African American woman with sickle cell disease comes to the emergency department with complaints of severe generalized body pain for 1 day.  She has been hospitalized for similar episodes in the past.  Her medications include folic acid, hydroxyurea, and hydrocodone as needed for pain. After initial evaluation, including pertinent laboratory studies and chest x-ray, she is started on 1/2 normal saline at 125 mL/hr and hydromorphone every 3 hours.  Over the next 36 hours, the patient complains of worsening chest pain and mild shortness of breath.  Her temperature is 38.9 C (102 F) , pulse is 112/min, and respirations are 23/min.  Oxygen saturation is 93% on 2 L O<sub>2</sub>.  Lung examination shows bilateral crackles.  Lower-extremity examination shows tenderness with palpation. Laboratory results are as follows: She has good urine output.  Her chest x-ray on admission (Image 1) and repeat x-ray after 36 hours (Image 2) are shown below. Which of the following, if instituted on initial presentation, may have helped prevent the clinical worsening that occurred in this patient? A) Antibiotic prophylaxis B) Hydromorphone PCA pump C) Incentive spirometry D) Inhaled bronchodilators E) Stringent use of intravenous hydration
Which of the following, if instituted on initial presentation, may have helped prevent the clinical worsening that occurred in this patient?

Definitions:

Necessary

In legal and ethical contexts, necessary refers to something that is required or indispensable to achieve a specific outcome or obligation.

Disaffirm

The legal act of renouncing or rejecting a contract or agreement, especially by a party who was not legally competent to enter it at the time of agreement.

Reasonable Value

The fair or market value of goods or services, as determined by considering the costs, demand, and any other factor relevant to an exchange.

Necessary

In legal and philosophical terms, necessary refers to something required, indispensable, or absolutely needed to achieve a certain outcome or fulfill a condition.

Related Questions

Q4: In the statement of facts section of

Q15: When the office legal memorandum involves more

Q30: A 48-year-old man comes to the emergency

Q32: Use the discriminant to determine what type

Q61: A 44-year-old woman is brought to the

Q93: A 67-year-old woman comes to the emergency

Q145: A 38-year-old woman is brought to the

Q153: A 45-year-old woman comes to the physician

Q155: A 23-year-old woman is brought to the

Q427: A 34-year-old woman comes to the office