A 70-kg 58-year-old man with unstable angina is scheduled to undergo coronary artery bypass grafting. Intravenous heparin and nitroglycerin are administered for four days before surgery. Before initiating cardiopulmonary bypass, 21,000 units of heparin are administered through the central venous catheter; five minutes later, activated clotting time is 280 seconds. Which of the following is the most appropriate next step in management?
In an adult undergoing laparotomy, which of the following is the most effective means of maintaining body temperature during the first hour of anesthesia?
(A) Increasing ambient temperature
(B) Using a warming blanket
(C) Warming inspired gases
(D) Warming intravenous fluids
(E) Warming irrigating fluids
A
Which of the following combinations of anesthetic and incorrect vaporizer results in the smallest error in delivered concentration?
A patient has fever and chills in the recovery room following an abdominal hysterectomy that required the intraoperative administration of whole blood 1 unit. A blood sample drawn in the recovery room shows no free hemoglobin. Subsequently, packed red blood cells 1 unit and fresh frozen plasma 1 unit are administered, and the fever and chills recur. The most likely cause of the fever and chills is
(A) an allergic-type transfusion reaction
(B) a hemolytic transfusion reaction to untested antibodies
(C) bacterial contamination of blood
(D) a reaction to leukocytes contained in the plasma
(E) the presence of cold agglutinins in the patient
D
A child undergoing general anesthesia is breathing spontaneously using the Jackson-Rees modification of the Ayres T-piece. Respiratory rate is 20/min and tidal volume is 75 ml. What is the minimum fresh gas flow required to prevent rebreathing?
Which of the following phenomena is primarily responsible for the decrease in core body temperature that commonly occurs during the first hour of general anesthesia?
(A) Convective heat loss from cutaneous vasodilation
(B) Decreased heat production
(C) Evaporative heat loss during skin preparation
(D) Heat loss from the respiratory tract
(E) Redistribution of core body heat to the periphery