A normotensive 66-year-old man undergoes total hip arthroplasty. Mean arterial pressure is maintained at 60 mmHg with isoflurane and labetalol; intraoperative FiO2 is 1.0. Eight units of red blood cells are administered intraoperatively because of an injury to the femoral artery. Five days later, the patient develops jaundice. Which of the following is the most likely cause of the jaundice?
Pain and spasm due to injury of the deltoid muscle is most effectively relieved by
(A) axillary block
(B) cervical sympathetic block
(C) interscalene brachial plexus block
(D) paravertebral block at C4
(E) superficial cervical plexus block
C
During a cardiac arrest with effective chest compression and positive-pressure ventilation, 50 mEq of sodium bicarbonate is administered. Which of the following is the most likely result?
An infant becomes cyanotic and hypotensive after ventilatory pressures increase to 45 cm H2O during closure of the abdominal wall at the end of a gastroschisis repair. The most appropriate next step is to
(A) administer a muscle relaxant
(B) administer 5% dextrose in lactated Ringer's solution 10 ml/kg
An 8-kg, 5-month-old infant undergoes craniotomy for an arteriovenous malformation. During the procedure, severe hemorrhaging occurs and packed red blood cells 3 units are transfused rapidly. During infusion of the third unit, hypotension, nodal bigeminy, and prolongation of the QT interval are noted. The most appropriate management includes administration of
A 30-year-old man is brought to the emergency department after being rescued from a house fire. With the trachea intubated and FiO2 at 1.0, arterial blood gas values are PaO2 495 mmHg, PaCO2 28 mmHg, and pH 7.28. Hemoglobin saturation measured by co-oximeter is 50%. The most appropriate next step is to