A patient receiving propranolol and nifedipine is scheduled for elective coronary artery bypass surgery. During induction with fentanyl and oxygen, heart rate decreases from 52 to 36 bpm and blood pressure decreases from 130/85 to 80/50 mmHg. Administration of atropine 2 mg intravenously has no effect. The most appropriate treatment at this time is administration of
A 36-year-old woman who undergoes peritoneal dialysis for chronic renal failure requires emergency surgical exploration for bowel obstruction. Serum creatinine concentration is 9.8 mg/dl and BUN concentration is 124 mg/dl. The most likely abnormality of coagulation is
(A) decreased euglobulin lysis time
(B) decreased platelet count
(C) prolonged activated partial thromboplastin time
A 34-year-old man has hyperkalemia-induced asystole. After initiating cardiopulmonary resuscitation, which of the following is the most appropriate next step in management?
(A) Administration of atropine
(B) Administration of calcium chloride
(C) Administration of sodium bicarbonate
(D) Transcutaneous pacing
(E) DC countershock at 200 joules
B
Which of the following decreases dead space in an anesthetic circle system?
(A) Larger surface area of the expiratory unidirectional valve
During repair for coarctation of the aorta in a healthy 13-year-old patient, right radial artery pressure increases from 100/60 to 105/70 mmHg after the aorta is cross clamped. This most likely indicates that
(A) collateral blood flow has decreased the hemodynamic consequences of cross-clamping
(B) left ventricular hypertrophy has decreased left ventricular compliance
(C) spinal cord blood flow is impaired
(D) the coarctation has decreased aortic diameter less than 50%
(E) the coarctation involves the origin of the right subclavian artery
During general anesthesia, a patient has the acute onset of atrial fibrillation with rapid ventricular response and hypotension to 50 mmHg systolic. The most appropriate treatment is