A 62-year-old man is in the intensive care unit after successful craniotomy for excision of a meningioma. Blood volume is normal; laboratory studies show serum sodium concentration of 120 mEq/L, serum osmolality of 260 mOsm/L, urine sodium concentration of 50 mEq/L, and urine osmolality of 820 mOsm/L. Which of the following is the most likely explanation?
(A) Fluid overload with 5% dextrose in water
(B) Inappropriate secretion of antidiuretic hormone
A 60-year-old man with type II diabetes mellitus requires emergency incision and drainage of a perirectal abscess. Laboratory studies show a serum glucose concentration of 850 mg/dl and a pHa of 7.30. The most appropriate management is administration of regular insulin and which of the following infusions?
(A) 5% Dextrose in water
(B) 5% Dextrose in 0.45% saline solution with potassium chloride
(C) 5% Dextrose in 0.45% saline solution with potassium chloride and mannitol
(D) Normal saline solution
(E) Normal saline solution and sodium bicarbonate
D
A 40-year-old patient has pain following injection of 8 ml of thiopental 2.5% through a right radial artery catheter. His hand remains pink. Which of the following is the most appropriate next step?
(A) Injection of lidocaine through the catheter
(B) Injection of nitroglycerin through the catheter
Syringe A contains 100 ml of normal blood with a PO2 of 2 mmHg, and syringe B contains 100 ml of normal blood with a PO2 of 98 mmHg. The contents of the two syringes are mixed anaerobicaily to equilibrium. The PO2 of the resultant mixture Is
In a healthy patient receiving an epidural analgesic infusion postoperatively, clear fluid is noted to drip back freely from the epidural catheter. Which of the following findings correctly identifies the associated fluid?
(A) Precipitation when mixed with an equal volume of pancuronium = local anesthetic