After 6 hours, Rati was transferred to the surgical holding unit within ED, awaiting for surgical team's review. You noticed that she then became tachycardic (HR 100 bpm), hyperthermic (Temp 38.3) and hypotensive (98/65 mmHg). Explain why such vital signs arise.

An 8-year-old boy undergoes surgical repair of an atrial septal defect that was deemed too large to close in the cardiac catheterization lab. There are no intraoperative complications and he is transferred to the pediatric cardiac intensive care unit (PCICU) on minimal ventilatory and inotropic support. He is appropriately extubated the following day. Over the next 12 hours, the trend in his vital signs shows progressively worsening tachycardia and decreasing systolic blood pressure. The pressure reading from an indwelling central venous line is significantly higher than what it was upon his admission to the PCICU. His heart sounds are muffled, there are no murmurs present, and his neck veins appear to be distended. His peripheral pulses are 1+. A chest radiograph shows an enlarged cardiac silhouette and small bilateral pleural effusions. His vital signs are pulse 118 beats/min, respirations 30 breaths/min, blood pressure 86/68 mmHg, and central venous pressure 12 mmHg.Of the following, which is the best next step to improve this patient’s hemodynamics?

Serious signs and symptoms of unstable tachycardia are usually NOT seen with ventricular rates less than:Question 57Answera.200 beats per minuteb.150 beats per minutec.120 beats per minuted.250 beats per minute

35yr old Rati presented to ED with sharp epigastric pain, radiating to her shoulder and back, associated with nausea and vomitting. Her pain score was 10/10, on examiniation, she has abdominal rigity and dimished bowel sounds. What are differential diagnoses based on Rati's presentation and assesement so far?

48. Which statement about tachycardia is NOT correct?  A heart rate of 175 bpm is within normal range for a child up to two A normal heart rate for an infant may be twice as fast as normal heart rate for an older child.  Sinus tachycardia IS commonly a dangerous rhythm that can quickly deteriorate to cardiac arrest. Tachycardia may be a normal, non-dangerous. heart rate in response to stress Ie anxiety.49. What is the primary therapy for hypovolemic shock?Fluid resuscitationCorrection of metabolic derangementsVasopressorsAntibiotics50. Pulse oximetry is monitored during post-resuscitation care to:Monitor hypoglycemia Optimize Ventilation and circulation Stabilize Blood pressure Monitor hypovolemia

complaining of excessive urination and constant hunger and thirst. She has no other complaints and no past medical history. Her family history is significant for hypertension, type 2 diabetes mellitus, and hyperlipidemia. She does not smoke but lives a sedentary lifestyle. On examination, she is afebrile with a blood pressure of 134/88 mmHg, heart rate of 84 beats per minute, and respiratory rate of 14 breaths per minute. The rest of her examination is normal. The patient is scheduled for a return visit to have fasting laboratory tests drawn. At her return visit, her blood pressure is 138/86 mmHg. Her fasting glucose is 156 mg/dL, and urine albumin-to-creatinine ratio is 200 mg/g. What is the next step in management for this patient?