07-28-2016, 08:58 AM
1..2 days after undergoing an aortic valve replacement for aortic stenosis, a 72-year-old woman develops ventricular fibrillation secondary to hypokalemia. The patient is a Jehovah’s Witness, and she and her family were adamant during preoperative consultation that no blood products be administered under any circumstances. Her hematocrit is 18%. Following successful resuscitation, she has severe abdominal pain. Her temperature is 38°C (100.4°F), pulse is 100/mm, and blood pressure is 100/70 mm Hg. She is being echanically ventilated. Abdominal examination shows rebound tenderness; bowel sounds are absent. Her hematocrit is 15%, and leukocyte count is 17,000/mm3. Intravenous antibiotic therapy is begun. Which of the following is the most apprTwo opriate next step?
A) Sign a do-not-resuscitate order
B) Administration of erythropoietin, intravenously
C) Administration of iron, intramuscularly
D) Transfusion of packed red blood cells
E) Exploratory laparotomy
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