You are called to a local physician's office where you find a 52-year-old male patient with a history of chronic renal failure. He is conscious but disoriented. The physician reports that the patient's wife brought him in because he has had a "chest cold," missed dialysis yesterday, and is now "acting strangely." Physical examination reveals cool, diaphoretic skin; edema to dependent areas, and
lung sounds with rhonchi in the right upper lobe. HR = 118, BP = 142/100, RR = 20 and deep, SaO2 = 97%, blood glucose = 79 mg/dL. Bloodwork performed by the physician in his office indicates a pH of 7.2. In addition to 15 liters per minute of oxygen by nonrebreathing mask and an IV of normal saline at a keep-open rate, which of the following is most appropriate for this patient in the prehospital setting?
A) IV sodium bicarbonate, 1 mEq/kg
B) IV magnesium sulfate, 10 gm
C) IV dextrose, 25 gm
D) IV furosemide, 120 mg
A
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Your patient is a 38-year-old female with a history of Crohn's disease. She is conscious and alert and complaining of abdominal pain. She describes a one-week history of increasingly diffuse, crampy abdominal pain. She also states that she has had nausea and vomiting, fever, and diarrhea the past two days. Physical examination reveals that her skin is warm and dry and that her abdomen is tender
to palpation in all quadrants with no masses or distension noted. HR = 100, BP = 118/78, RR = 14, SaO2 = 99%. Which of the following treatments is appropriate in the prehospital management of this patient? A) Diphenydramine B) Ketorolac (Toradol) C) Methylprednisolone D) Antiemetics
A previously healthy 5-year-old female presents with swollen axillary lymph nodes and fever. The physician notes multiple scratches and papules on her hands and arms
The mother reveals they had adopted a new kitten about two weeks ago, and it had scratched the child numerous times. She said she cleaned and treated the scratches with hydrogen peroxide immediately after each occurrence. Using the information provided, this infectious disease state requires A) No antibiotic therapy because the infection will resolve on its own B) A culture of the kitten to determine the specific infective organism C) Antibiotic therapy for adequate treatment D) Confirmation using a biopsy and culture of the lymph nodes