What is the correct position of a patient for a lumbar puncture procedure?

Palliative care is focused on symptom management for those approaching the end of life. Hospice care is focused on support and preparation for the final hours, days, and week(s) of life. 

A 65 year old female presents to the emergency department with sudden onset right sided weakness, right facial droop, and expressive aphasia. Medical history: hypertension, diabetes, atrial fibrillation. She reports she forgot to take her medications yesterday and this morning. Last known well time 1hr 15mins prior to arrival. Vitals signs: temp 98.3F, pulse 80, BP 205/110, RR 22, O2 92%. Glucose 195 Brain CT without contrast reveals no acute findings. Head & Neck CTA reveals a left MCA occlusion. Home medications: Metoprolol 75mg BID, lisinopril 5mg daily, apixaban (Eliquis) 5mg BID, Glipizide 5mg daily, Metformin 1000mg BID True or False: This patient is a candidate for administration of tissue plasminogen activator (t-PA).

You are rounding in the medical intensive care unit. The nurse notifies you that your patient, who is being treated for meningitis, has had a neuro exam change. Upon entering the patient room, you notice the patient is experiencing fluttering eyes, full body muscle spasms, and loss of consciousness. All non essential items are removed from the patient’s bed and supportive care is provided. What is the initial medication and dose will you have the nurse administer? 

A 52 year old male was referred to neurology for progressive weakness, hyperreflexia, spasticity, muscle atrophy, with intact sensation intact. What neurological disorder are these symptoms most associated to?

All of the following are predisposing factors for embolic stroke EXCEPT:

What electrolyte is not recommended to be replaced for the first 24 hours post-operative?

A 32 year old female presents to the emergency department after being thrown from a horse. Chest x-ray reveals a “dropped lung”. A chest tube is inserted into the pleural space and blood collects into the chest tube container. What is the patient’s diagnosis? 

Which clinical finding is associated with cardiogenic shock? 

A 56 year old male presents to the emergency department with complaints of sudden onset left sided weakness, slurred speech, and partial loss of sensation to his left arm/hand. Brain CT without contrast reveals no acute abnormality. Head & Neck CTA reveal a right MCA occlusion. EKG: Atrial fibrillation, heart rate 105. Glucose 120. Vital signs: temp 98.2F, pulse 105, BP 170/95, RR 22, O2 96% on room air. Home medications: Lisinopril 10mg daily, pantoprazole 40mg before breakfast.  Last known well time 1.5 hours prior to arrival.  True or False: This patient is a candidate for tissue plasminogen activator (t-PA).