Match each patient presentation with the most appropriate disposition or care setting transition.
- A 68-year-old with community-acquired pneumonia, acute confusion, blood urea nitrogen of 25 mg/dL, respiratory rate of 34/min, and blood pressure of 88/50 mmHg.Intensive Care Unit (ICU)
- A 55-year-old with acute pulmonary embolism, stable blood pressure, echocardiographic evidence of right ventricular dysfunction, and elevated serum troponin.Intermediate Care / Telemetry Unit
- A 62-year-old recovering from an ischemic stroke, medically stable, who requires and can actively participate in 3 hours of intensive therapy daily.Inpatient Rehabilitation Facility (IRF)
- A 45-year-old with severe acute pancreatitis, hemodynamically stable but requiring prolonged, slow weaning from mechanical ventilation via tracheostomy.Long-Term Acute Care Hospital (LTACH)
- A 79-year-old recovering from an open reduction and internal fixation of a hip fracture, medically stable, who requires daily physical therapy but fatigues after 45 minutes.Skilled Nursing Facility (SNF)
Answer
The correct matches align specific clinical severity and functional capacity scores with their respective care settings.
Each presentation matches criteria for specific care settings: CURB-65 ≥ 3 warrants ICU; intermediate-high risk PE warrants telemetry; ≥ 3-hour therapy tolerance warrants IRF; prolonged mechanical ventilation warrants LTACH; and < 3 hours therapy tolerance warrants SNF.
Step-by-Step Solution
Key Concept
Appropriate disposition requires matching a patient's medical acuity, severity scoring (e.g., CURB-65), hemodynamic stability, and functional rehabilitation tolerance (e.g., 3-hour rule for IRF vs SNF) to the appropriate level of care.