A 70-year-old man undergoes cross clamping of the aorta for repair of an abdominal aneurysm. Which of the following methods is most appropriate for decreasing hypotension associated with removal of the cross clamp?
(A) Administration of a phenylephrine bolus when the cross clamp is removed
(B) Correction of any base deficit with sodium bicarbonate during clamping
(C) Decrease of anesthetic to allow blood pressure to increase to 20% above preclamp levels
(D) Volume loading to increase pulmonary artery occlusion pressure prior to removal
(E) Infusion of dopamine 10 minutes prior to removal
A 33-year-old primigravid woman with myasthenia gravis, well-controlled with pyridostigmine, is in labor with the cervix dilated 7 cm. She has a headache and feels very nervous. Blood pressure is 160/115 mmHg, she has 3+ pitting edema, and urinalysis shows 4+ protein. Appropriate management of her labor should include
(A) lumbar epidural block with bupivacaine 8 ml of 0.5% solution
A patient has pain in the left thoracic wall associated with metastatic rib lesions. An intrathecal neurolytic block with 6% phenol in glycerin is planned for pain relief. Prior to performing the block, the patient should be placed in which of the following positions?
Ten days after sustaining burns over 40% of his body surface area, a patient requires greater than expected doses of vecuronium for adequate relaxation of skeletal muscle. The primary cause is increased
With long-term administration, which of the following drugs produces the most prolonged sedative effect of diazepam?
(A) Cimetidine
(B) Famotidine
(C) Metoclopramide
(D) Ranitidine
(E) Warfarin
A
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
The newborn infant of an 18-year-old heroin addict has an initial Apgar score of 1. After intubation of the trachea and ventilation with pure oxygen, the Apgar score is 3 at five minutes. Appropriate management at this time would include administration of each of the following EXCEPT