01-31-2010, 08:59 AM
A 73-year-old recently widowed African-American woman comes to the emergency department because of abdominal pain, nausea and constipation for the past 3 days. She says the pain has been intermittent and she has had severe nausea and left-sided stomach cramps. She alternates between being constipated and having diarrhea but she has not had a bowel movement in the past 36 hours. She admits to smoking one pack of cigarettes per day, and she has diabetes mellitus that is poorly controlled with diet and glyburide. Vital signs now are: temperature 37.8°C (100.8°F), pulse 100/min, respirations 28/min and blood pressure 180/90 mm Hg. Abdomen is distended and tender; rectal examination is positive for occult blood. X-ray film is shown. Which of the following is the most appropriate management at this time?
A) Discharge home with clear fluids
B) Exploratory laparotomy
[C) Nasogastric tube
D) Oral antibiotics
E) Rectal tube
confused between ng tube or rectal tube
A) Discharge home with clear fluids
B) Exploratory laparotomy
[C) Nasogastric tube
D) Oral antibiotics
E) Rectal tube
confused between ng tube or rectal tube