An 83-Year-Old Caucasian Male with a History of Advanced Colon

question 155

Multiple Choice

An 83-year-old Caucasian male with a history of advanced colon carcinoma with metastasis to the lungs develops right-sided hemiplegia and dysarthria while at home.  His granddaughter calls you at 8:00 p.m., giving you a history compatible with a cerebrovascular event, probably an ischemic stroke.  You know this patient from before.  He is not a hospice patient, and he has always firmly expressed his decision to not be resuscitated.  He has a current, valid DNR (do not resuscitate) order.  Which of the following is the most appropriate next step in the management of this patient?

• A)Give him pain medication and aspirin and follow-up tomorrow in the office.
• B)Admit him to the hospital.
• C)Explain to her that you will arrange for hospice early in the morning.
• D)Tell her the patient's prognosis is poor and leave him at home.

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