A 58-year-old with cirrhosis and hematemesis arrives pale an…

A 58-year-old with cirrhosis and hematemesis arrives pale and clammy. Two large-bore IVs are placed; octreotide is started; 1 L LR given and 1 unit PRBCs is infusing. Current data: BP 85/50 mm Hg, HR 118/min, RR 24/min, SpO₂ 96% on 2 L NC, urine output 10 mL in the last hour. Which bedside measurement signals the need for the most immediate intervention?

Use the chart below in answering questions 2 and 3. Be sure…

Use the chart below in answering questions 2 and 3. Be sure to work questions 2 and 3 on the chart you printed out, and fill in your chart with all the information just like we did in the lectures. Be sure to fill in your chart with all the information just like we did in the lectures.

A 62-year-old with hepatitis C cirrhosis develops progressiv…

A 62-year-old with hepatitis C cirrhosis develops progressive sleep–wake reversal and difficulty concentrating after missing several doses of lactulose. Exam: disoriented to date, mild jaundice, flapping tremor. Vitals: BP 114/70, HR 90, RR 18, SpO₂ 98% RA. Morning labs: serum ammonia 98 µmol/L (elevated), total bilirubin 3.9 mg/dL, albumin 2.8 g/dL, sodium 131 mEq/L, glucose 118 mg/dL. Which abnormality most directly accounts for the current neurologic findings?