A healthy 10-kg child is flushed and restless after premedication with meperidine 15 mg and scopolamine 0.2 mg intramuscularly. His skin is warm and dry; temperature is 38°C, pulse is 130 bpm, and blood pressure is 90/60 mmHg. The most likely cause is
A 35-year-old woman with a grade III subarachnoid hemorrhage is undergoing clipping of a middle cerebral artery aneurysm 48 hours after initial hemorrhage. Which of the following drugs used to induce hypotension is LEAST likely to affect intracranial pressure?
Five minutes after intrathecal administration of tetracaine 12 mg in hyperbaric solution, a 60-year-old man has a weak hand grasp. Respirations are normal, heart rate has decreased from 80 to 45 bpm, and blood pressure has decreased from 150/80 to 90/50 mmHg. The most appropriate management at this time is
(A) administration of atropine
(B) administration of ephedrine
(C) administration of phenylephrine
(D) placement of the patient in the head-down position
A 20-year-old woman with poorly controlled diabetes mellitus is scheduled for urgent drainage of an abdominal abscess. She received an initial dose of regular insulin 10 units followed by regular insulin 5 units/hr for the past five hours. Laboratory studies show serum sodium concentration 128 mEq/L, potassium 5.4 mEq/L, chloride 80 mEq/L, and glucose 750 mg/dl. The most appropriate perioperative management is
(A) addition of subcutaneous NPH insulin
(B) administration of sodium bicarbonate to correct metabolic acidosis
(C) administration of normal saline solution to correct the presumed hypovolemia
(D) administration of furosemide to correct hyponatremia
(E) infusion of 5% dextrose in 0.2% saline solution to prevent hypoglycemia
Compared with the response of a normal patient, administration of a bolus dose of pancuronium (0.15 mg/kg) to a patient with cirrhosis and ascites would be associated with