01-21-2009, 07:24 PM
33. A 45-year-old woman comes to the emergency department because of shortness of breath, chest pain, dizziness, and mild numbness and tingling around the lips for 2 hours. She says that she feels like she is going to die. She had three similar episodes last week when she was vacationing at the Grand Canyon; the first episode occurred while crossing a narrow bridge on a donkey. She takes a hypoglycemic drug for type 2 diabetes mellitus, verapamil for hypertension, and sumatriptan as needed for migraine. She is mildly diaphoretic and appears pale. Her blood pressure is 130/90 mm Hg, pulse is 120/min, and respirations are 28/min. Serum glucose level is 120 mg/dL. An ECG shows sinus tachycardia. Sublingual nitroglycerin therapy does not relieve her symptoms and gives her a headache. The most appropriate next step in management is administration of which of the following?
A
) Haloperidol
B
) Lorazepam
C
) Oxygen
D
) Sumatriptan
E
) Verapamil
A
) Haloperidol
B
) Lorazepam
C
) Oxygen
D
) Sumatriptan
E
) Verapamil