A 26-Year-Old Primigravida at 38 Weeks Gestation Is Admitted to the Hospital

question 136

Multiple Choice

A 26-year-old primigravida at 38 weeks gestation is admitted to the hospital due to preeclampsia with severe features.  She undergoes an emergency cesarean delivery of a healthy newborn.  After delivery, the patient continues to have uncontrolled hypertension and suffers an ischemic stroke.  She is intubated and placed on full ventilator support.  On day 3 of hospitalization, the patient remains minimally responsive to most stimuli.  She has no advance directive.  The physician explains the clinical findings and options for care to the patient's husband and parents.  The husband says he met his wife 2 years ago and does not recall discussing life-sustaining medical treatment with her.  The patient's parents state that it would be best to continue life support because the patient just became a mother.  In further discussion with the family, which of the following would be most important for the physician to address?

• A)Family's perceptions of the patient's wishes
• B)Husband's preference for the patient's treatment
• C)Likelihood that the patient will not have a meaningful recovery
• D)Parents' preference for the patient's treatment
• E)Risk of medical complications with prolonged mechanical ventilation

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