A 36-year-old woman who undergoes peritoneal dialysis for chronic renal failure requires emergency surgical exploration for bowel obstruction. Serum creatinine concentration is 9.8 mg/dl and BUN concentration is 124 mg/dl. The most likely abnormality of coagulation is
(A) decreased euglobulin lysis time
(B) decreased platelet count
(C) prolonged activated partial thromboplastin time
During cardiopulmonary resuscitation (CPR) in an adult, external chest compression is being performed at the rate of 90/min with 2 inches of sternal depression and a compression-relaxation ratio of 20:80. The most appropriate action is to
A combined epidural and general anesthetic is used for aortofemoral bypass surgery. Just prior to extubation, the patient received morphine 5 mg through the epidural catheter. Eleven hours later, he is unresponsive while breathing 40% oxygen from a face mask. Respiratory rate is 6/min and SpO2 is 92%. Arterial blood gas analysis shows PaO2 80 mmHg, PaCO2 84 mmHg, and pH 7.16. Which of the following statements concerning this patient is true?
(A) Hypercarbia is contributing to the decreased level of consciousness
(B) Naloxone is ineffective for reversing the respiratory depression
(C) The oxygen saturation is higher than expected because of the pH
(D) The risk for respiratory depression would have been lower with subarachnoid administration of 0.5 mg morphine
(E) Residual local anesthetic is contributing to the respiratory depression
A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of