A 64-year-old female presents with a 5-day history of exerti…

A 64-year-old female presents with a 5-day history of exertional dyspnea and orthopnea. Her medical history is significant for SLE and diastolic heart failure. Chest X-ray reveals significant bilateral pleural effusions. The decision is made to perform a thoracentesis.  Which laboratory value would indicate that the effusions are a result of her known diagnosis of SLE?

The AG-ACNP is seeing a 70-year-old female patient with a si…

The AG-ACNP is seeing a 70-year-old female patient with a significant history of COPD and 3 months status post right total knee replacement who woke up this morning with severe dyspnea. The chest x-ray was inconclusive of pertinent findings, therefore a CT of the chest was completed. The CT angiogram of the chest was positive for a pulmonary embolism in the right upper lobe. Two hours later the patient’s vital signs changed and she is now tachycardic to 130s, blood pressure 64/48, respiratory rate 30, SaO2 80%. The AG-ACNP identifies this type of shock as:

In addition to smoking cessation and vaccinations that inclu…

In addition to smoking cessation and vaccinations that include influenza and pneumococcal, which of the following should be included in the management of a patient with mild or Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease stage I COPD?

A 65-year-old female with a history of severe COPD and coron…

A 65-year-old female with a history of severe COPD and coronary artery disease is intubated for severe acute respiratory distress syndrome (ARDS) in the setting of pneumonia. Despite ventilation with 6 mL/kg tidal volumes and neuromuscular blockade, PaO2:FiO2 remains 85 on FiO2 100%. PEEP is increased from 5 to 10 cm H2O, and mean arterial pressure subsequently decreases from 65 to 45. In what setting is increased PEEP least likely to improve oxygenation and hemodynamics?

An intubated patient is receiving enteral nutrition. Today s…

An intubated patient is receiving enteral nutrition. Today she has a new onset fever, leukocytosis, and increased sputum production. Chest x-ray demonstrates right lower lobe (RLL) infiltrate. Which of the following interventions is most beneficial to decrease the incidence of this complication?