tikka
Forum Senior
Topics: 53
Posts: 116
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A 48-year-old woman with diabetes mellitus is brought by her ex-husband and son to the emergency department following a suicide attempt by overdosing on "some pills". She has been depressed and saw a counselor after her husband left her for his secretary. She has had a hard time dealing with the separation and has, according to her son, become withdrawn lately. He knows that she was receiving some psychiatric medication from her primary care physician because of pain related to her diabetes mellitus. She has flushed dry SKIN , dilated pupils, tachycardia, and confusion. After the bottles are checked, it seems that the patient overdosed on amytriptyline. The family is concerned about her. They feel she needs to deal with her psychiatric problem. The most appropriate intervention at this time is to
A. admit her to Psychiatry for further treatment
B. admit her to the intensive care unit
C. admit her to the medical floor
D. call Psychiatry to schedule an outpatient clinic appointment
E. talk to her ex-husband about the need to get marital counseling
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| msyamp
Forum Fanatic
Topics: 60
Posts: 1,462
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B initial treatment
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| nadiabarati
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Why not C? Please explain it?
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| Diego Casali
Forum Elite
Topics: 7
Posts: 232
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The correct answer is B because this is a life - threatening problem!
Patient's life comes first, then you will deal with her psychiatric problems.
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| ndspider
Forum Senior
Topics: 5
Posts: 69
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The answer is C. Don't admit her to the ICU, give her NA HCO3- and wait till she stabilizes and then send her for a pscy evaul.
Intensive care??? no way.
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| abarbaryan
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B
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| Diego Casali
Forum Elite
Topics: 7
Posts: 232
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The association between possible cardiac toxicity and comorbid diabetes mellitus would make this suicidal patient an ideal candidate for monitoring in ICU.
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| zubr
Forum Junior
Topics: 14
Posts: 61
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Mild to moderate poisoning with amitriptyline is not life - threatening problem.
Symptoms usually appear within 30 to 60 minutes of ingestion, and reach their peak intensity within 4 to 12 hours.
When did she take pills? Is she on the peak or she is going to a coma?
But to easy!!!!
The pain related to her diabetes mellitus that need tricyclic antidepressant - diabetes should be bad?
Did any one check glucose?
Hyperosmolar Hyperglycemic Nonketotic Coma?
B. admit her to the intensive care unit
Edited by zubr on 06/23/06 - 08:37 PM
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