A 41-Year-Old Man with a History of Bipolar Disorder Is

question 139

Multiple Choice

A 41-year-old man with a history of bipolar disorder is brought to the emergency department by his mother for confusion and agitation that she noticed while visiting today.  The patient denies suicidal ideation and intentional overdose of his medication or illicit drugs.  His only known medication is lithium.
His temperature is 37.2° C (99° F) , blood pressure is 94/52 mm Hg, pulse is 89/min, and respirations are 18/min.  The patient's pulse oximetry is 96% on room air.  Examination shows dry mucous membranes, clear lung fields, and normal first and second heart sounds.  The patient has a flat affect and does not answer most questions.  He has a significant tremor in both hands.

Electrocardiogram shows normal sinus rhythm.  Intravenous fluids are initiated.
Which of the following is the most appropriate next step in management?

• A)Activated charcoal
• B)Forced diuresis
• C)Hemodialysis
• D)Ipecac
• E)Whole-bowel irrigation

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Definitions:

Breast-milk Feedings

The act of feeding an infant milk directly from the mother's breast or from the mother's expressed milk.

Control Group

In experimental research, the group of participants that does not receive the experimental treatment, serving as a baseline for comparison.

Experimental Treatment

A procedure or intervention applied in a controlled environment to observe its effects on a variable of interest, typically to validate hypotheses in research.

Randomly Assigned

A method in experimental design where subjects are allocated to groups or conditions in a way that is free of bias and unpredictable.