The AG-ACNP is caring for a 79-year-old male who has been su…

The AG-ACNP is caring for a 79-year-old male who has been successfully resuscitated. He had a sudden, witnessed collapse in a shopping mall where he was found to be in pulseless VT. He has a prior history of CAD with a single coronary stent placed 2 years ago. He now has stable vital signs but remains comatose. His 12-lead ECG shows ST segment depressions in the anterior leads. Which statement regarding the role of cardiac catheterization in his care is true?  Cardiac catheterization is:

An unrestrained driver presents to the ED after a head-on mo…

An unrestrained driver presents to the ED after a head-on motor vehicle crash with airbag deployment. The patient is awake and alert. GCS = 15. Vital signs: heart rate 94, blood pressure 138/78, respiratory rate 28, and SpO2 99% on room air. Chest wall is symmetrical, but tender to palpation. Breath sounds are diminished throughout related to shallow respirations. Chest x-ray is negative for any acute changes. Initial management should include which of the following?

An 83-year-old male who was on the telemetry unit for a hear…

An 83-year-old male who was on the telemetry unit for a heart failure exacerbation has been transferred to the intensive care unit due to new onset atrial fibrillation with a rapid ventricular response. He was given a diltiazem bolus followed by a continuous diltiazem infusion without successful rate control. It has been less than 48 hours and direct current cardioversion is being considered. The success of electrical cardioversion is inversely proportional to which of the following?

A 45-year-old male with morbid obesity (BMI 55) presents to…

A 45-year-old male with morbid obesity (BMI 55) presents to the ED at 6 AM with right leg pain, and cellulitis that has kept him awake all night. He is admitted to the ward and his fevers and skin examination are improved with antibiotics during the first 16 hours of hospitalization. At 2 AM you are called to evaluate the patient for ICU admission because of somnolence and hypoxemia (SpO2 falling to high 70s on 2LNC). The rapid response team had difficulty waking the patient and ABG was performed before your arrival in the patient’s room: 7.29/74/52. Following arterial puncture, the patient woke up and by your arrival he is able to converse but remains sleepy with eyes closed, denying dyspnea, with SpO2 now 92% on 2LNC, and normal work of breathing. Medication history was reviewed, and no opiates have been administered. The ward team is requesting ICU transfer because of acute hypercarbic respiratory failure and initiation of BiPAP. You review recent laboratory test results and note that serum bicarbonate has been 38 to 40 over the last 6 months.Which of the following statements is true?

A 24-year-old female presents to the ED with a complaint of,…

A 24-year-old female presents to the ED with a complaint of, “My heart is pounding out of my chest and I’ve been short of breath for 4 hours.” She has had similar episodes, but all have spontaneously stopped. She is in good health and takes no medications. Her blood pressure is 120/80 mmHg and pulse too rapid to count. Her rhythm is shown in the following ECG. ECG2.jpg What is the most appropriate immediate management for this patient?