A 76-year-old woman is brought to the hospital with a 1-hour h | Surgery collections Videos and quizez 2021

A 76-year-old woman is brought to the hospital with a 1-hour history of confusion. Her husband says that the patient started having an occipital headache 2 hours ago and took acetaminophen and went to bed. An hour later, he had difficulty waking her up and found her confused. The patient's medical history is significant for coronary artery disease, diabetes mellitus type 2, hypertension, and persistent atrial fibrillation. She underwent coronary artery bypass grafting 8 years ago. Her current medications include apixaban, metoprolol, lisinopril, insulin glargine, and insulin aspart. She is an ex-smoker with a 30-pack-year smoking history, and she drinks a glass of wine daily. The patient lives with her husband and is independent in her daily activities. Her temperature is 37.9 C (100.2 F), blood pressure is 170/100 mm Hg, and pulse is 70/min and irregular. The patient is somnolent but wakes up with painful stimuli and withdraws all 4 extremities to pain. She is unable to follow simple commands and mumbles a few unintelligible words. Deep tendon reflexes are symmetric and Babinski sign is absent bilaterally. Fingerstick blood glucose is 110 mg/dL