ICU To Ward Transition Practice Test

A 72-year-old man is transferred to the medical ward from the ICU, where he was treated for septic shock from a urinary source for five days. His infection has resolved, and he was weaned off norepinephrine 24 hours prior to transfer. His ICU course was complicated by delirium, for which he received a continuous midazolam infusion that was weaned off 12 hours ago. On the ward, he is now noted to be agitated, tremulous, and diaphoretic. His temperature is 37.5°C (99.5°F), blood pressure is 165/95 mm Hg, heart rate is 115/min, and respiratory rate is 22/min. Physical examination reveals no focal findings.

A 65-year-old woman is transferred from the ICU to the general medical floor after a 12-day stay for ARDS requiring prolonged mechanical ventilation. She was successfully extubated 48 hours ago. On examination, she is alert but demonstrates marked, symmetric, flaccid weakness in all four limbs, with decreased deep tendon reflexes. Sensation to light touch and pinprick is intact. She has difficulty lifting her arms off the bed and cannot support her own weight to stand. She is hemodynamically stable and her respiratory status is satisfactory on room air.