A 78-Year-Old Woman Is Brought to the Emergency Department Due

question 948

Multiple Choice

A 78-year-old woman is brought to the emergency department due to sudden-onset, right-sided hemiplegia and right-sided facial droop.  Medical history is significant for chronic kidney disease and hypertension.  The patient has a history of medication nonadherence and does not remember the names of her prescribed medications.  Temperature is 37 C (98.6 F) , blood pressure is 218/128 mm Hg, pulse is 84/min, and respirations are 15/min.  On examination, the patient is mildly lethargic but able to converse.  Cranial nerve examination shows upper-motor-neuron, right-sided facial weakness.  Muscle strength is 0/5 in the right upper and lower extremities.  CT scan of the head, immediately performed, is shown in the exhibit. 

Laboratory results are as follows: Which of the following is the best next step in management of this patient?

• A)Administration of intravenous nicardipine
• B)Observation without treatment
• C)Surgical evacuation of hematoma
• D)Transfusion of fresh frozen plasma
• E)Transfusion of packed red blood cells

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Definitions:

Feelings of Inferiority

Emotional sentiments where an individual perceives themselves as less than others in some capacity, often leading to low self-esteem.

Strive for Success

The strong desire or determination to achieve success in life, often through hard work, dedication, and perseverance.

Fromm's Theory

A psychoanalytic theory developed by Erich Fromm that focuses on the human need for freedom and the ways societal structures can impede or foster personal development.

Kelly's Theory

A psychological framework proposing that people develop personal constructions of reality to understand their experiences and guide their behavior.