10-09-2006, 07:19 AM
A 24-year-old white female is brought to the emergency room (ER) with altered mental status. Her mother, who is accompanying her, says that her daughter was otherwise healthy but suffered from viral gastroenteritis 4 days ago. Since that time, she has been on oral fluids. Over the past 2 days her condition has been deteriorating and she declines admission to the hospital. Her past history is not significant, except that she has been losing weight for the past couple of months, and has been drinking a lot of water. On examination she has rapid deep breathing and is afebrile. Physical exam is unremarkable except signs of dehydration. Her vitals are: BP: 100/56 mm of Hg; PR: 120/min regular and weak; Temperature: 37.2C(99.F}; RR: 28/min. Pulse oximetry: 94% on room air. What is the most appropriate next step in management?
A. Obtain EkG
B. Obtain arterial blood gases
C. Finger stick glucose
D. Intubate the patient
E. Obtain CT scan of head
A. Obtain EkG
B. Obtain arterial blood gases
C. Finger stick glucose
D. Intubate the patient
E. Obtain CT scan of head