A 34-Year-Old Previously Healthy Man Was Admitted to the Intensive

question 542

Multiple Choice

A 34-year-old previously healthy man was admitted to the intensive care unit after a motor vehicle collision 3 days ago in which he was the unrestrained driver.  The patient sustained traumatic brain injury and blunt chest trauma, which are being managed nonoperatively.  He has had episodes of hypotension, which improved after fluid resuscitation and packed red blood cell transfusion.  He is mechanically ventilated and is receiving enteral feeding via the nasogastric tube.  Today, the patient is noted to have black liquid stool that is heme-positive.  He has had no fever or high gastric residuals.  The abdomen is nondistended and soft with normal bowel sounds.  Laboratory results are as follows: Which of the following would have been most effective at preventing this patient's current condition?

• A)Addition of probiotics to the enteral feeding
• B)Avoidance of the hypotensive episodes
• C)Delaying of the enteral feeding
• D)Proton pump inhibitor administration
• E)Transfusion of fresh frozen plasma

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Definitions:

Yerkes-Dodson Law

A theory suggesting there is an optimal level of arousal for performance, and that too little or too much arousal can adversely affect task performance.

Physiological Arousal

The physical state of being alert, involving physiological changes like increased heart rate, muscle tension, and heightened senses.

Musical Performance

The act of presenting music in front of an audience, involving vocal or instrumental sounds.

Coherence

The quality of being logical, consistent and clear; often used to describe how well parts of a whole fit together meaningfully.