A patient comes to his primary care clinic complaining of kn…

A patient comes to his primary care clinic complaining of knee pain. His blood pressure is found to be 132/80 mmHg. The nurse notes that the last time the patient visited the clinic, nine months ago, his blood pressure was 138/74 mmHg. The patient says, “I don’t understand how it could be high because I feel fine.” The best response by the nurse is:

A 54-year-old female with PMH significant for alcoholic cirr…

A 54-year-old female with PMH significant for alcoholic cirrhosis and recurrent esophageal varices, who recently underwent transjugular intrahepatic portosystemic shunt (TIPS) placement, is brought to the emergency room by her daughter due to somnolence. Starting this morning, the patient has appeared sleepy, difficult to arouse, and slow to respond to questions. On physical exam, temperature is 98.6ยบ F, BP 98/56 mmHg, pulse is 72/min, and respirations are 14/min. She repeatedly falls asleep during examination. With arms outstretched and wrists dorsiflexed, flapping of the hands is observed. Which of the following is the most appropriate treatment for this patient?