BC, a 34-year-old male works at a bank downtown. At 1930, he…
BC, a 34-year-old male works at a bank downtown. At 1930, he is found unresponsive in his office. According to his co-worker, he appeared “OK”, talkative and friendly when he arrived at work. He went to lunch, returned to the office, and continued to work well into the evening. A member of the housekeeping team found him laying behind his desk, unresponsive with a laceration on his forehead. She called 911 and security for help. He is taken to the emergency room via ambulance. His secretary is called as his contact. She states he is usually very productive at work, but recently has seemed preoccupied and anxious. She notes he always has a lot of energy but lately has been coming into work late, seems agitated and sluggish, and continually complains about how “expensive” things are. She says he is in good health yet has had several nose bleeds at work. He says he always gets nose bleeds when it’s dry outside. In the emergency room the admitting nurse takes his VS and conducts her assessment:Vital Signs: BP: 197/120 mmHg P: 125/minute R: 24/minute T: 39C (102.4F) O2 sat: 98% (FiO2=0.21)Eyes: Pupils mydriatic, equalHeart: Tachycardia, no murmursLungs: Equal bilaterally, clear to auscultationAbdomen: Bowel sounds normalNeurologic: Moaning unintelligibly, flailing all extremities, spontaneously opens eyesSkin: Flushed, diaphoretic The admitting nurse states: “I need some help to control this guy!” “He’s going to fall off the bed!” The patient then has what appears to be a tonic-clonic seizure lasting approximately 60 seconds. She suspects the patient has been using an illicit substance and is experiencing toxicity. She immediately rules out narcotic overdose due to the presence of the following signs and symptoms: Select all that apply.