A32 year old g1p0 at 33 weeks ega comes into the emergency department complaining of a severe headache. she has contractions every 3 minutes. she is experiencing flashes of light in front of her eyes. her pregnancy has been uncomplicated until this time, and her only medical problem is mild asthma. her vital signs are: t 36.5 c (97.7 f), bp 172/114, p 78, r 14, and a room air spo2 99%. her lungs have bilateral crackles at the bases, and her cervix is dilated at 3 cm and effaced at 50%. her urinalysis has 2+ protein, and her complete blood count shows: wbc 8,000/mm3, hematocrit 38%, platelets 215,000/mm3. her bun and creatinine are normal, her ast is 250 u/l, and her alt is 316 u/l. the electronic fetal monitor shows a reactive and variable heart tracing at a rate in the 150s. what is the appropriate next step in management for her?

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The parents of a 9-year-old girl bring their daughter to the ed. for the last 12 hours, the child has suffered severe nausea and vomiting, as well as diarrhoea and abdominal cramps. further discussion with the child indicates that she suffers from blurred vision and headache. the parents originally were worried about bringing the child to the ed because they feared deportation since the family are illegal immigrants employed to pick strawberries on a nearby farm. on direct questionning, the parents admit that the child was assisting with spraying crops with pesticides the previous day. none of the family members was wearing any protecting clothing. her bp is 88/48 mmhg, pulse is 90/min, rr 33/min, temp 38 c. the child appears sweaty and confused. auscultation of the lungs reveals a diffuse wheeze bilaterally. pupils are miotic and the child has diffuse muscle weakness. which of the following interventions is the most appropriate treatment? - atropine- charcoal- glucagon- naloxone- exposure: consider organophosphate poisoning, which inhibits cholinesterase and results in accumulation of ach in both muscarinic and nicotinic sites. pralidoxime activates achatropine competes with ach only at muscarinic receptors, but will not reverse nicotinic effectscharcoal = gastric decontaminationglucagon = reverse beta-blocker overdosenaloxone = reverse effects of opioids

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