Solved

A 62-Year-Old Man Is Hospitalized for an Elective Coronary Artery

question 586

Multiple Choice

A 62-year-old man is hospitalized for an elective coronary artery bypass graft surgery. The patient has been having exertional chest pain and was found to have a left main coronary artery disease. Other medical issues include hypertension, hyperlipidemia, and stage 3 chronic kidney disease. The patient is a retired financial advisor with a 50-pack-year smoking history. He undergoes the surgery without operative complications and is successfully extubated the next day. Postoperative medications include atorvastatin, metoprolol, and morphine. On the third postoperative day, the patient is found to be progressively drowsy, lethargic, and difficult to rouse. Temperature is 36.1 C (97 F) , blood pressure is 110/68 mm Hg, pulse is 112/min and irregular, and respirations are 9/min and shallow. Examination shows flat neck veins and mild bibasilar lung crackles. Pupils are 1 mm and equal. The patient withdraws all extremities equally to pain. ECG shows atrial fibrillation with rapid ventricular response. Fingerstick glucose level is 125 mg/dL. Laboratory results are as follows: The laboratory findings are not significantly changed compared to preadmission values. Which of the following is the most appropriate next step in management of this patient's altered mental status?

Definitions:

Negatively Worded

Refers to items or statements framed in a manner that uses negative expressions, often used in surveys or assessments to check consistency of responses.

Archival Study

A research method in which the researcher examines existing records or databases to find answers to research questions.

Case Study

A descriptive account of the behavior, past history, and other relevant factors concerning a specific individual.

Survey

A survey is a research method used for collecting data from a predefined group of respondents to gain information and insights on various topics of interest.