Two days after coronary artery bypass grafting, a 62-year-old man remains sedated, tracheally intubated, and mechanically ventilated with full neuromuscular block. Over the next three hours, Pa02 decreases from 90 to 70 mmHg at an Fl02 of 0.7, peak inspiratory pressure measured proximally in the ventilatory circuit increases from 40 to 66 cmH20, and plateau pressure remains unchanged at 30 cmH20. Which of the following is the most likely cause of these changes?
(A) Adult respiratory distress syndrome
(B) Bronchial mucus plugging
(C) Left ventricular failure
(D) Lobar pneumonia
(E) Tension pneumothorax
B
During controlled ventilation, which of the following will cause an increase in end-tidal carbon dioxide tension with a normal waveform on the capnograph?
(A) Bronchospasm
(B) Rapid blood loss
(C) Ventricular fibrillation
(D) Endobronchial migration of the endotracheal tube
During active labor, 10 ml of bupivacaine 0.5% with epinephrine 1:200,000 is administered epidurally. Fifteen minutes later, maternal blood pressure is 70/50 mmHg and heart rate is 70 bpm; fetal heart rate is 90 bpm for 45 seconds, with loss of beat-to-beat variability. The most likely explanation for the fetal vital signs is
During pulmonary artery catheterization, a 65-year-old man receives morphine 6 mg and scopolamine 0.4 mg intravenously. The pulse oximeter indicates desaturation, which quickly resolves with stimulation. When the drapes are removed, he has unilateral eye pain, decreased visual acuity, and dilated and irregular pupils. These eye symptoms are most likely caused by
A 57-year-old man who weighs 150 kg and is 170 cm (67 in) tall is scheduled for cholecystectomy. He has a 100 pack-year smoking history. Which of the following findings on pulmonary function testing are most likely?
Upon removal of the epidural catheter after uneventful labor and delivery in a 25-year-old primiparous woman, approximately 1.2 cm of the Teflon catheter is left behind in the epidural space. The patient is informed of the complication. The most appropriate management is