A 76-Year-Old Man Comes for Outpatient Follow-Up After Recent Coronary

question 76

Multiple Choice

A 76-year-old man comes for outpatient follow-up after recent coronary artery bypass grafting surgery.  He has abundant, yellowish wound discharge from the lower part of the surgical midsternal wound.  The patient has no chest pain, dyspnea, fevers, or abdominal swelling.  He underwent uncomplicated coronary artery bypass grafting surgery for severe coronary artery disease 9 days ago, which included internal thoracic artery harvesting.  Medical history also includes hypertension and type 2 diabetes mellitus.  The patient is afebrile, and vital signs are within normal limits.  On examination, the sternum appears stable to palpation.  There is swelling and soft tissue separation at the lower part of the wound with copious discharge.  Which of the following is the next best step in managing this patient?

• A)Chest and sternal imaging
• B)Intensive glucose control and observation
• C)Oral, broad-spectrum antibiotics
• D)Topical antibiotics
• E)Wound culture and observation

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Definitions:

Accounts Receivable

Money owed to a company by its customers for sales or services on credit, considered a current asset on the balance sheet.

Allowance for Doubtful Accounts

A contra-asset account used to estimate and offset the amount of receivables that may not be collected.

Uncollectible Accounts

Accounts receivable that a company does not expect to collect due to customer defaults.

Bad Debt Expense

The estimated amount of credit sales that are not expected to be collected, representing potential loss to the company.