A 26-year-old woman has headache, nausea, and photophobia 36 hours after cesarean delivery for chorioamnionitis using subarachnoid block. Temperature is 38.8°C and leukocyte count is 14,200/mm3. Which of the following is the most appropriate next step in management?
A 62-year-old man, who had a myocardial infarction three years ago, complicated by congestive heart failure and renal failure, is undergoing a colectomy. A pulmonary artery catheter demonstrates a cardiac output higher than measurements recorded during a cardiac catheterization two months after the infarction. Which of the following most likely contributes to the increased cardiac output?
(A) Creation of an arteriovenous fistula
(B) Increased hemoglobin concentration from 10 to 12 g/dl
(C) Stimulation of carotid body receptors
(D) Transcutaneous nitroglycerin
(E) Use of a beta-adrenergic blocker to prevent myocardial reinfarction
Eight hours after abdominal surgery, a 51-year-old patient becomes increasingly somnolent. Epidural morphine 5 mg was administered immediately following the procedure. Postoperatively, respiratory rate has not decreased below 12/min and Sp02 has remained greater than 92%. Arterial blood gas analysis shows Pa02 80 mmHg, PaC02 82 mmHg, and pH 7.1. Which of the following is the most appropriate conclusion?
(A) Analysis of the blood sample was delayed
(B) The blood sample was venous rather than arterial
A 2500-g, 12-hour-old infant is tracheally intubated and mechanically ventilated at a rate of 20/min with an FiO2 of 0.4 and peak inspiratory pressure of 25 cmH2O. At birth, amniotic fluid was meconium stained and Apgar scores were 2 and 7. The most recent arterial blood gas levels are PaO2, 50 mmHg, PaCO2, 55 mmHg, and pH 7.20. The most appropriate management is to
(A) administer sodium bicarbonate
(B) begin intravenous infusion of prostaglandin E,