A patient becomes flushed, dyspneic, and hypotensive during transfusion of 1 unit of packed red blood cells in the PACU. After discontinuing the transfusion, the most appropriate next step is administration of
A 4-month-old child undergoing a craniectomy for craniosynostosis is anesthetized with nitrous oxide and halothane. Suddenly the systolic blood pressure decreases from 75 to 30 mmHg, and the PetCO2 decreases from 35 to 6 mmHg. Which of the following maneuvers is LEAST likely to have a beneficial effect?
(A) Administration of a fluid bolus
(B) Administration of a vasopressor
(C) Application of positive end-expiratory pressure
(D) Discontinuation of nitrous oxide
(E) Flooding the surgical wound with saline solution
A 45-year-old man is scheduled for exploratory laparotomy. Six months ago, he received doxorubicin (Adriamycin) therapy for testicular cancer. This patient is at increased risk for
While checking an anesthesia machine, opening the oxygen flow-control valve yields no oxygen flow, although the wall-mounted oxygen pipeline supply gauge reads 50 psig. Opening the backup oxygen cylinder results in normal oxygen flow. The most likely cause is
(A) failure of the oxygen pipeline supply
(B) failure of the second-stage oxygen pressure regulator
(C) a malfunctioning check valve in the oxygen pipeline supply inlet
A 75-year-old man is confused, restless, and disoriented two days after an aortic aneurysm repair. Serum sodium concentration is 112 mEq/L, serum osmolality is low, and urine is hypertonic. The most appropriate treatment is
(A) restriction of fluid intake
(B) administration of isotonic saline solution
(C) administration of hypertonic (3%) saline solution
(D) administration of spironolactone
(E) infusion of mannitol 25 g
C
The concentration of bupivacaine is higher in maternal blood than in fetal blood because
(A) bupivacaine is metabolized in the placenta
(B) maternal blood has a higher pH
(C) maternal blood has greater plasma protein binding
(D) maternal hemoglobin has a higher affinity for bupivacaine
A patient who had liver transplantation two years ago now requires general anesthesia for ENT surgery. Minimal rejection has occurred on a regimen of cyclosporine and prednisone. Which of the following is most likely?