sfk
Forum Elite
Topics: 43
Posts: 294
|
A 71-year-old man presents to the hospital with an episode of bright red blood per rectum. The patient reports that, a few hours ago, he passed a grossly bloody bowel movement. The passage was associated with some cramping, lower abdominal pain. The patient's past medical history is significant for coronary artery disease and a myocardial infarction 3 years ago. He is poorly compliant with his beta blocker and diuretic therapy, and his blood pressures have run around 140/85 mm Hg. While the patient is on the floor, he has another episode of large-volume, bright red blood per rectum. His blood pressure is 100/60 mm Hg while supine, and his pulse is 120/min. His hematocrit is 28%. He then begins to complain of substernal chest tightness radiating to his left shoulder. An ECG shows new T wave inversions in the anterior leads. Which of the following is the most appropriate intervention at this juncture?
Which of the following is the most appropriate intervention at this juncture?
A. Administration of aspirin by mouth
B. Administration of a beta blocking agent
C. Administration of nitroglycerin sublingually
D. Administration of nitroglycerin topically
E. Blood transfusion
___________________
Forum Elite, But Step 2 Newbie....
|
| peter90036
Forum Elite
Topics: 28
Posts: 315
|
he probably has ischemia from hypoxemia due to anemia. low Hct, Tachycardia
from what i been imprinted by doing UW i'd say Blood Transfusion...
|
| heartblock
Forum Newbie
Topics: 4
Posts: 50
|
Peter I love your avatar..nice one!
|
| peter90036
Forum Elite
Topics: 28
Posts: 315
|
|
| ganesha123
Forum Elite
Topics: 10
Posts: 284
|
blood transfusion.. i guess..
___________________
It has never been so bad, that it couldn't be worse...”
|
| guangyu
Forum Elite
Topics: 29
Posts: 308
|
E
beta blocking agent and nitroglycerin not for Hypotention
|
| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,245
|
 Agree
___________________
The elevator to succes is broke ,you must take the stairs
|
| drhouse
Forum Senior
Topics: 21
Posts: 192
|
i agree with u people but y not aspirin coz he is having MI
___________________
everybody can do it.... its just matter of time
|
| guangyu
Forum Elite
Topics: 29
Posts: 308
|
pt is bleeding, you can not give aspirne
|
| sfk
Forum Elite
Topics: 43
Posts: 294
|
blood tranfusion is the right answer.
no aspirin, pt is bleeding.
no nitrate or beta blocker coz pt is hypotensive.
his myocardial ischemia would benefit from a transfusion.
___________________
Forum Elite, But Step 2 Newbie....
|
| mildus
Forum Guru
Topics: 19
Posts: 614
|
Nice expl, sfk.
Aspirin isn't given since the pt is bleeding at the moment, and since he probably doesn't have thrombosis but infarction due to anemia, so blood transfusion
|
|
| |
| | | | | | | | | | | |
