Postoperatively, a patient is being mechanically ventilated by a constant-flow, pressure-cycled ventilator with the following initial settings: inspiratory/expiratory (I/E) ratio of 1:2, peak inspiratory pressure (PIP) of 25 cmH2O, and rate of 10/min. One hour later, the I/E ratio is 1:4. Which of the following would ensure that the minute ventilation is the same as that initially set?
(A) Inflate the endotracheal tube cuff to prevent leakage
(B) Double the respiratory rate
(C) Decrease the expiratory pause until the I/E ratio is 1.0
A celiac plexus block effectively relieves pain at which of the following sites?
(A) Abdominal viscera above the pelvis
(B) Parietal peritoneum above the pelvis
(C) Pelvic parietal peritoneum
(D) Pelvic viscera
(E) Visceral pleura
A
A 58-year-old man with a history of angina is undergoing resection of an abdominal aortic aneurysm under morphine, nitrous oxide, d-tubocurarine anesthesia. Just before removal of the aortic cross-clamp, heart rate is 74 bpm, blood pressure is 115/70 mmHg, and pulmonary artery occlusion pressure is 7 mmHg. Immediately after removal of the cross-clamp, heart rate increases to 120 bpm, blood pressure decreases to 80/55 mmHg, and pulmonary artery occlusion pressure decreases to 3 mmHg. The V5 lead on the EKG demonstrates sudden ST-segment depression and T-wave inversion. Initial therapy should be
(A) reapplication of the aortic cross-clamp
(B) intravenous administration of sodium bicarbonate
(C) initiation of a phenylephrine infusion
(D) rapid expansion of blood volume by transfusion
In the diagram, point "X" represents a patient with severe left ventricular dysfunction. The points labeled 1, 2, and 3 each represent the results of a different therapeutic intervention. Which of the following represents the most likely intervention at each point?