The following hemodynamic values are obtained two hours after coronary artery bypass surgery: Cardiac index 1.7 L/min/m2; Pulm Art. Occ. Pressure 22 mmHg; MAP 60 mmHg; Urine volume 0.2 ml/kg/hr. The most appropriate management is
After inflation of both the tracheal and endobronchial cuffs of a left-sided double-lumen tube, the following are noted on auscultation of the chest: Left lumen clamped --> Breath sounds absent bilaterally; Right lumen clamped --> Breath sounds present on left only; Both lumens open --> Breath sounds present on left only. The most appropriate action is to
(A) decrease the endobronchial cuff volume
(B) decrease the tracheal cuff volume
(C) reinsert the tube, rotating it 180 degrees to the right
(D) suction both lumens
(E) withdraw the tube slightly and repeat the auscultory maneuvers
An 8-kg, 1-year-old boy is scheduled for a bilateral inguinal hernia repair. If regional anesthesia is to be used for post-operative analgesia, which of the following statements is true?
(A) Caudal administration of 0.25% bupivacaine will provide analgesia without evidence of motor block
(B) Caudal administration of 0.125% bupivacaine is as effective as caudal administration of 0.25% bupivacaine
(C) Caudal analgesia is more difficult to achieve in young children than in adults
(D) The recommended volume of local anesthetic used for caudal analgesia in children is 3 ml per year of age
(E) The volume of 0.25% bupivacaine required for bilateral ilioinguinal and iliohypogastric nerve blocks would be too large
A moderately obese 38-year-old woman is using patient-controlled morphine analgesia one day after open cholecystectomy. While breathing room air, oxygen saturation is 85%, Pa02 is 48 mmHg, PaC02 is 42 mmHg, and pH is 7.36. In addition to administration of oxygen, the most effective management is to
(A) decrease the dosage of opioids
(B) change to epidural morphine
(C) administer an inhaled bronchodilator
(D) initiate 4 cm of nasal continuous positive airway pressure
(E) initiate incentive spirometry therapy
E
Which of the following findings is most likely in patients with acute transection of the spinal cord at the level of C6?
(A) Autonomic hyperreflexia
(B) Hyperkalemia with administration of succinylcholine
Following induction of anesthesia with sufentanil and pancuronium, a patient with left main coronary artery disease has a decrease in blood pressure from 110/70 to 60/40 mmHg. There is no change in heart rate or ECG. The most appropriate management of the hypotension is administration of