Mitchell Susan L
N Engl J Med. 2015 Jun 25;372(26):2533-40. doi: 10.1056/NEJMcp1412652.
An 89-year-old male nursing home resident with a 10-year history of Alzheimer’s disease presents with a temperature of 38.3°C, a productive cough, and a respiratory rate of 28 breaths per minute. Nurses report that for the past 6 months he has been coughing at breakfast and having trouble swallowing. He has profound memory deficits, no longer recognizes his daughter (who is his health care proxy), is bedbound, is able to mumble a couple of words, and is unable to perform any activities of daily living. The nurse asks whether he should be hospitalized. How should this patient be evaluated and treated?
一名89岁男性养老院居民,有10年阿尔茨海默病病史,体温38.3°C,咳嗽伴咳痰,呼吸频率为每分钟28次。护士报告称,在过去6个月里,他早餐时咳嗽,吞咽困难。他有严重的记忆缺陷,不再认识他的女儿(其女儿是他的医疗代理人),卧床不起,只能含糊地说几个词,无法进行任何日常生活活动。护士询问是否应将他住院治疗。该患者应如何评估和治疗?