A 2.8-kg 8-hour-old infant undergoes laparotomy for a ruptured omphalocele. Following primary closure of the abdominal wall, arterial blood gases are PaO2 40 mmHg (FiO2 0.6), PaCO2 55 mmHg, and pH 7.1. Blood pressure is 30/20 mmHg. After increasing the FiO2, the most appropriate action would be to
(A) obtain a radiograph of the chest immediately
(B) withdraw the endotracheal tube 1 cm
(C) assess the patient for coexisting congenital heart disease
(D) administer lactated Ringer's solution 15 ml/kg
Each of the following increases cardiac output EXCEPT
(A) an arteriovenous fistula
(B) fever
(C) normovolemic anemia
(D) shivering
(E) carotid sinus stimulation
E
A blood sample is taken from a patient whose body temperature is 30°C. In which direction will the pH, PCCX, and P02 change when measured in the blood gas machine at 37°C? (pH, PCO2, PO2)
(A) Increase Decrease Decrease
(B) Decrease Increase Increase
(C) Decrease Increase No change
(D) No change Increase Increase
(E) No change No change Increase
B
Each of the following is an adverse effect of intranasal administration of cocaine prior to nasotracheal intubation EXCEPT
(A) complete heart block
(B) hypertension
(C) myocardial ischemia
(D) seizures
(E) ventricular tachycardia
A
A patient with end-stage renal disease has prolonged ventilatory depression after administration of morphine. The most likely cause is increased
An 8-year-old child with chronic renal failure is scheduled for an operation to create an arteriovenous fistula. Laboratory studies include: Hemoglobin 6.5 g/dl, Blood gases (breathing air) : PaO2 97 mmHg, PaCO2 29 mmHg, pH 7.30 Sodium 129 mEq/L Potassium 5.5 mEq/L Chloride 101 mEq/L Bicarbonate 15 mEq/L. Before inducing general anesthesia, which of the following abnormalities should be corrected?
(A) Anemia
(B) Metabolic acidosis
(C) Potassium concentration
(D) Anemia, metabolic acidosis, and potassium concentration
A child has tachypnea immediately after reintubation for intractable laryngospasm. Oxygen saturation is 78% at an FiO2 of 1.0. A radiograph of the chest taken 15 minutes later is most likely to show
(A) bilateral pleural effusions
(B) diffuse homogenous pulmonary infiltrates
(C) patchy central infiltrates of the right upper lobe