Which of the following increases blood flow to the lower lobe of the right lung?
(A) Collapsing the right lung during anesthesia
(B) The expiratory phase of spontaneous ventilation
(C) The inspiratory phase of mechanical ventilation
(D) Moving from the supine to the upright position
(E) Moving from the supine to the left lateral decubitus position
C
Which of the following statements concerning successful blockade of the femoral nerve is true?
(A) It requires that a paresthesia be elicited prior to injection
(B) It provides motor blockade below the knee
(C) It is accomplished with an injection medial to the femoral artery
(D) It permits surgery for entrapment of the lateral femoral cutaneous nerve
(E) It provides anesthesia to the anterior thigh
E
A 64-year-old patient with chronic obstructive pulmonary disease sustained fractures of ribs 4 through 8 on the left one hour ago. Examination shows agitation, heart rate of 120 bpm, respiratory rate of 30/min, and blood pressure of 180/100 mmHg. PaO2 is 70 mmHg and PaCO2 is 35 mmHg on room air. Radiographs of the chest show no abnormalities. Which of the following is the most appropriate immediate management?
(A) Continuous epidural analgesia using local anesthetics
(B) Mechanical ventilation
(C) Infusion of midazolam
(D) Patient-controlled analgesia with morphine sulfate
A 70-kg, 77-year-old man Is undergoing left nephrectomy with nitrous oxide, oxygen, fentanyl, and midazolam anesthesia. He has a 90 pack-year history of cigarette smoking and has chronic obstructive pulmonary disease. One hour after incision, expiratory wheezing occurs and peak Inspiratory pressure increases from 35 to 65 cmH20; end-tidal PCO2 is unchanged, but SpO2 decreases from 97% to 88%. The most likely cause is