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* nbme
  doc_sim - 11/15/06 15:07
  You have been treating a 5 -month -old child in the neonatal intensive care unit (NICU). He was delivered at 26 weeks' gestation by cesarean delivery because of premature rupture of membranes. The mother is 18 years old and is unemployed. There are two other children in the home. The father is not living with them, and he has not been in contact with the mother. The mother rarely visits the NICU. The infant had severe respiratory distress syndrome at birth and required dopamine for blood pressure support. His condition progressed to pulmonary interstitial emphysema and bronchopulmonary dysplasia by 4 weeks of age. At 4 months of age he required a tracheostomy and medication for control of his blood pressure. Now, at 5 months of age, the boy has a cardiac arrest requiring resuscitation and placement of chest tubes. He then develops seizures that are eventually controlled with medication. The neonatologist feels that the child will always require life support. The mother refuses to discuss the possibility of withdrawing life support. Her insurance is Medicaid. The hospital bill for this child is now US350,000.

Item 1 of 2
To guide further treatment at this time, it is most important to assess which of the following?

A ) The extent of neurologic injury

B ) The financial impact on the family

C ) The mother's level of understanding of the child's prognosis

D ) Whether another family member is better suited to make decisions about the patient's care

E ) Your state's law regarding futile care

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* Re:nbme
  knock_knock - 11/15/06 15:12
  think C. ?  
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* Re:nbme
  alexis - 11/15/06 15:20
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* Re:nbme
  natka - 11/15/06 15:35
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* Re:nbme
  alexis - 11/15/06 15:39
  E maybe??  
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* Re:nbme
  doc_sim - 11/15/06 15:44
  i am confused. ithought E would be definitive answer.  
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* Re:nbme
  humerus - 11/15/06 22:26
  will go with e too
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* Re:nbme
  anila_indian - 11/16/06 13:10
  A to remove life support i think  
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* Re:nbme
  drasija - 11/16/06 16:07
  A// to remove life support, brain death is the only criteria.......i its better to assess the child's neurological injury.

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* Re:nbme
  dr_nuri - 11/16/06 17:13
  i wd say c...  
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* Re:nbme
  coping - 11/16/06 17:37
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