The PTA is seeing Mr. Jones for PT secondary to post-op TKA…

The PTA is seeing Mr. Jones for PT secondary to post-op TKA x 2 days. The patient is on oral pain medication, ROM is 35-74 degrees and MMT 3/5 for available ROM. While working on bed mobility and transfers Mr. Jones complains of light headedness, nausea, and feeling like he is going to pass out. What should the PTA do?

A 58-year-old male is seen in the ED for syncope. His wife r…

A 58-year-old male is seen in the ED for syncope. His wife reports that she was in the kitchen when she heard him fall on the living room floor. He recalls feeling very lightheaded but remembers nothing more. Upon further questioning, he recalls feeling dizzy on several occasions over the past few months. He has a history of hypertension and a myocardial infarction 10 years earlier. He has since been well and exercises on a daily basis. In the ED, he has a blood pressure of 95/55 mmHg and a heart rate of 30 beats/min. An ECG is obtained (see the following ECG).  ECG1.jpg What is the most important initial step in managing this patient? 

A 26-year-old woman with no prior medical history presents t…

A 26-year-old woman with no prior medical history presents to the emergency department (ED) with progressively worsening dyspnea for 1 week. Her symptoms are preceded by 3 days of fever, rigors, and nasal congestion. She is afebrile with HR of 116 beats/min and BP of 92/70 mmHg. Physical examination reveals bilateral rales, elevated jugular venous pressure, 2/6 systolic murmur at the left lower sternal border, cool extremities, and 2+ bilateral lower extremity edema. Echocardiogram reveals LVEF of 20%, nondilated LV (LV end-diastolic diameter of 3.4 cm), global hypokinesis, mild mitral regurgitation, and a normal right ventricular function. Labs are significant for creatinine of 1.6 mg/dL, aspartate aminotransferase (AST) of 385 U/L, alanine aminotransferase (ALT) of 413 U/L, troponin I of 4.8 ng/mL, and serum lactic acid of 2.8 mmol/L. Intravenous diuretics and dobutamine are initiated. Within 24 hours of admission, the patient develops hypotension and worsening heart failure refractory to inotropes and vasopressors. Urine output is 125 cc in the last 6 hours.  Which of the following is the best next step in her management to stabilize her?