Postoperatively a 70-kg patient has a serum sodium value of 130 mEq/L. To increase this value to 140 mEq/L would require the administration of how much sodium in mEq?
Which of the following is the most important factor affecting the incidence of postoperative pulmonary complications?
(A) Age of the patient
(B) Anesthetic technique
(C) Duration of surgery
(D) Obesity
(E) Site of the operation
E
An elderly man has an acute dissection of the descending thoracic aorta. Which of the following antihypertensive therapies is most likely to extend the dissection?
(A) Esmolol infusion
(B) Nitroglycerin infusion
(C) Nitroprusside infusion
(D) Nitroprusside infusion combined with a beta-adrenergic blocker
A 32-year-old patient with end-stage renal failure has irreversible neuromuscular blockade two hours after tracheal intubation with a muscle relaxant. Which of the following is the most likely cause?
A 30-year-old, 70-kg woman with mitral stenosis is scheduled for elective laparoscopic sterilization. Preoperatively she is taking digoxin and an unknown medication for chronic mental depression. The EKG demonstrates atrial fibrillation. Heart rate is 68 bpm. Anesthesia is induced with thiopental followed by nitrous oxide 50%, halothane 0.75%, and a continuous succinylcholine infusion. The ventilator is set to deliver a minute volume of 5 liters through an endotracheal tube. As the carbon dioxide is being insufflated into the abdomen, the blood pressure is noted to be elevated (150/100 mmHg) and ventricular bigeminy is present. The most appropriate therapy is to
(A) increase the halothane concentration to 1.25%
(B) discontinue the succinylcholine infusion
(C) increase minute ventilation to 7.5 L/min
(D) administer potassium 5 mEq intravenously over one minute followed by propranolol 0.25 mg
(E) measure arterial blood gas and serum electrolyte values
An anesthetized, paralyzed patient is placed in the lateral position and mechanically ventilated. End-tidal PCO2 is 34 mmHg and PaCO2 is 43 mmHg. This gradient
(A) increases during spontaneous breathing
(B) indicates increased dead space ventilation
(C) is caused by increased intrapulmonary shunt
(D) reflects inhibition of hypoxic pulmonary vasoconstriction
Which of the following complications is more likely to occur during cannulation of the left internal jugular vein than during cannulation of the right internal jugular vein?