Journal #5611
Posted 15 years ago2009-01-29 15:37:25 UTC
A 5-day-old child is brought to the emergency department because he has been difficult to arouse over the last 6 hours. His parents report that he has not been interested in feeding today and that he has been breathing rapidly and with a grunting noise. On physical examination, the infant's heart rate is 185 beats/min, respiratory rate is 80 breaths/min, and blood pressure is 55/40 mm Hg. A pulse is palpable in the right brachial region, but not in the feet. All of his extremities are cool and mottled, with a capillary refill of more than 2 seconds.
Of the following, the MOST appropriate next step is to
arrange for echocardiography at the first appointment in the morning
initiate a furosemide infusion
initiate a prostaglandin infusion
obtain a computed tomography scan of the head
obtain a lumbar puncture
Of the following, the MOST appropriate next step is to
arrange for echocardiography at the first appointment in the morning
initiate a furosemide infusion
initiate a prostaglandin infusion
obtain a computed tomography scan of the head
obtain a lumbar puncture
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WARNING: baby.exe takes roughly 9 months to reboot. By ending process, you will not lose any unsaved emotional data. It will just turn into sadness.
Prostaglandin causes vasodilation of the ductus arteriosus. This baby has coarchtation of the aorta, and when oxygenated blood traverses through the aorta after birth, the ductus starts shutting down, causing a hypoperfusion state in the systemic circulation.
EDIT:
Lol.