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A 64-Year-Old Man Is Brought to the Emergency Department by Ambulance

question 497

Multiple Choice

A 64-year-old man is brought to the emergency department by ambulance for right-sided weakness and slurred speech that started 30 minutes ago. The wife reports that her husband said he was dizzy, and shortly after, he developed acute right arm and leg weakness and was unable to speak. Medical history includes hypertension, for which he takes amlodipine. The patient also takes an aspirin daily. Blood pressure is 225/110 mm Hg, pulse is 90/min, and respirations are 20/min. On examination, the patient is alert but aphasic with 0/5 strength in the right upper and lower extremities. Examination of the left upper and lower extremities is normal. A nicardipine infusion is started and CT scan of the head is performed. After returning from the CT scanner, the patient is minimally responsive and has developed hyperextension of all four extremities. CT scan shows a left-sided intracerebral hemorrhage with a 5-mm midline shift to the right. Which of the following is the best next step in management of this patient?

Definitions:

Feelings

Emotional states or reactions that are subjective and experienced internally, influenced by personal perceptions, thoughts, and experiences.

Cognitive Dissonance

The psychological discomfort experienced by an individual who holds two or more contradictory beliefs, ideas, or values at the same time, leading to tension and the motivation to reduce the dissonance by changing beliefs or behaviors.

Festinger

Leon Festinger, a social psychologist known for his theory of cognitive dissonance, which describes the discomfort felt when holding conflicting ideas or beliefs.

Media Influence

The effect that media, such as television, internet, and advertising, have on the attitudes, behaviors, and values of the people who are exposed to it.