Question

A 24-year-old female is evaluated in the hospital for 8/10 abdominal pain. She was admitted one day ago for cholecystitis, and an open cholecystectomy was performed today. She was previously healthy. Medications are ceftriaxone and acetaminophen. Temperature is 37.5 C (99.5 F), pulse is 100 beats/minute, respiratory rate is 28 breaths/minute, blood pressure is 120/80 mmHg, and oxygen saturation is 95% on room air. On physical exam, she appears uncomfortable and anxious. Her surgical incision from this morning is intact without erythema. She is tender near the surgical incision. Lungs are clear to auscultation bilaterally. Cardiovascular exam reveals no murmur and normal S1 and S2. What is the most appropriate step in management of this patient? A. Arterial blood gas B. Chest radiograph C. Computed tomography pulmonary angiogram (CTPA) D. Intravenous (IV) morphine E. Nebulized albuterol

Answer 1

The most appropriate step in the management of this patient is to perform a chest radiograph.

Step-by-step explanation:

The most appropriate step in the management of this patient is to perform a Chest radiograph (B).

Given the patient's symptoms of abdominal pain and tenderness near the surgical incision, it is important to rule out potential complications such as pneumonia or atelectasis. A chest radiograph can help identify any abnormalities in the lungs that may be causing the patient's symptoms.

Performing an arterial blood gas (A) would not be necessary in this case, as the patient's oxygen saturation is already at 95%. A computed tomography pulmonary angiogram (CTPA) (C) would be indicated if the patient had symptoms suggestive of a pulmonary embolism, such as sudden onset shortness of breath or chest pain. Giving intravenous (IV) morphine (D) or nebulized albuterol (E) would not address the underlying cause of the patient's symptoms.

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