A patient's glucometer reads 39 mg/dL. The patient is alert, but confused. The patient's son states that he has a friend who becomes unresponsive when his sugar is less than 50 mg/dL; therefore, the reading on his father cannot be correct. Which one of the following statements would be your best response?
A) "You are probably right; I feel comfortable in having him sign a refusal."
B) "I agree. Anyone with a blood sugar less than 50 should be unconscious."
C) "The response to a low blood sugar can vary from patient to patient."
D) "I agree. Just to be safe, I am not going to give him any oral glucose."
C
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A 36-year-old female patient with a history of asthma is admitted to the ICU from the emergen-cy department. Her respirations are 30, very labored, with accessory muscle use and bilateral in-spiratory and expiratory wheezing
There is bilateral hyperresonance during chest percussion. A blood gas taken in the ICU after 1 hour of continuous aerosolized albuterol (15 mg) reveals: pH 7.38, partial pressure of carbon di-oxide (PaCO2) 42 mm Hg, partial pressure of oxygen (PaO2) 53 mm Hg, oxygen saturation (SaO2) 88%, bicarbonate (HCO3?) 25 mEq/L with nasal cannula 6 L/min. The patient is 5'5" and weighs 135 lb. The most appropriate action at this time is which of the following? a. Continue current therapy with 20 mg al-buterol and reassess in 1 hour. b. Noninvasive positive pressure ventilation (NPPV) with bilevel positive airway pres-sure (bilevel PAP), f = 12, inspiratory pos-itive airway pressure (IPAP) 28 cm H2O, expiratory positive airway pressure (EPAP) 3 cm H2O, fractional inspired ox-ygen (FIO2) 0.30 c. Intubate, use pressure-controlled continu-ous mandatory ventilation (PC-CMV), f = 8, peak inspiratory pressure (PIP) 28 cm H2O, TI 0.75 seconds, positive end-expiratory pressure (PEEP) 3 cm H2O, FIO2 1.0 d. Intubate, use volume-controlled continu-ous mandatory ventilation (VC-CMV), f = 12, tidal volume (VT) 600 mL, PF 40 L/min, PEEP 5 cm H2O, FIO2 0.60
Divide the fractions. 5/7 รท 4/5 =
Fill in the blank(s) with the appropriate word(s).