A 56-Year-Old, Previously Healthy Man Is Admitted to the Intensive

question 177

Multiple Choice

A 56-year-old, previously healthy man is admitted to the intensive care unit for acute respiratory distress syndrome due to viral pneumonia.  The patient requires prolonged mechanical ventilation with deep sedation, prone positioning, and paralytic agents.  He develops hypoactive delirium, which slowly improves with sedation washout.  After 7 days, the patient is successfully extubated and discharged to a skilled rehabilitation center.  A week later, he is participating in daily physical therapy.  The patient requires 2-person assistance to stand due to diffuse weakness.  He has been irritable and confused in the evenings and is prescribed zolpidem to assist with sleep.  Montreal Cognitive Assessment score is 25/30, with deficits in attention and memory.  Neurologic examination reveals flattened affect and mild psychomotor retardation.  He is on extended sick leave from his job as an air traffic controller.  Which of the following statements best represents this patient's long-term prognosis?

• A)He is likely to have memory and concentration deficits for years
• B)He is likely to have complete resolution of mood and sleep symptoms in 2 weeks
• C)He is likely to require a wheelchair indefinitely
• D)He is likely to require lifelong supplemental oxygen therapy
• E)He is likely to require opportunistic infection prophylaxis for 6 months

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Definitions:

Normal Sinus Rhythm

The standard rhythm of a healthy heart, characterized by the sinus node generating a steady pace of electrical pulses.

PQRST Complex

A series of deflections in an electrocardiogram (ECG) that represent the electrical activity during one heartbeat, including depolarization and repolarization of the atria and ventricles.

Sinus Bradycardia

A slow heartbeat rate originating from the natural pacemaker of the heart, often considered normal in healthy individuals but can indicate underlying health issues.

Electrodes

Conductive pads or plates that transmit electrical impulses, often used in medical monitoring or treatment.