need help for cms surgery 2.. - anagh

[ArchivalUser]

1..Five days after undergoing incision and drainage of a left inguinal sebaceous cyst, a 57-year-old man comes to the emergency department because of an 8-hour history of moderate scrotal pain. He has type 2 diabetes mellitus, coronary artery disease, and hypercholesterolemia. His medications are a quinolone, sulfonylurea,
p-adrenergic blocking agent, and statin. His temperature is 38.9°C (102°F), pulse is 120/mm and regular, and blood pressure is 90/50 mm Hg. Examination of the scrotum shows edema and tenderness at the base; there is a 3-cm black surgical incision with surrounding erythema extending to and including the site of the sebaceous cyst. Laboratory studies show:
Leukocyte count 21,000/mm3
Segmented neutrophils 70%
Bands 7%
Eosinophils 3%
Lymphocytes 20%
Serum
Na 130 mEq/L
K÷ 3.4 mEq/L
C1 94 mEq/L
HC03 l7mEq/L
Glucose 324 mg/dL

Intravenous administration of 0.9% saline and insulin is begun. Which of the following is the most appropriate next step in management ?

A) Application of warm compresses to the operative site
B) Hyperbaric oxygen therapy
C) Initiation of intravenous antifungal therapy
D) Initiation of intravenous potassium therapy
E) Surgical debridement

[ArchivalUser]

Ee

[ArchivalUser]

an E

[ArchivalUser]

D

Potassium is critically low, and insulin will drive it into the cell

[ArchivalUser]

I put D but it was wrong.

[ArchivalUser]

I took the same logic as u took.

[ArchivalUser]

In real life, shouldn't start insulin with potassium that low. Or can give potassium and insulin together. Also, as soon as you see the black surgical incision, you'd call an emergency surgical consult and surgery will get him to the OR STAT. But I'm sure that before he gets to the OR or the surgery even begins, someone can give him the potassium.

I think they are just trying to test if we understand the gravity of the situation.

[ArchivalUser]

Thank you guys