A patient with jaundice who has a minimally elevated SGOT (AST), markedly elevated alkaline phosphatase, and normal prothrombin time is to receive a muscle relaxant. Which of the following is most likely in this patient?
A patient has tonic movements of the head and neck, nystagmus, and slurred speech after receiving metoclopramide for nausea after nitrous oxide-opioid anesthesia. The most appropriate pharmacologic treatment is
A 76-year-old patient is restless and hallucinating in the preoperative holding area. He received morphine 5 mg and scopolamine 0.4 mg intramuscularly as premedication and is now breathing oxygen 2 L/min through nasal prongs. SpO2 is 98%. Which of the following is the most appropriate next step?
(A) Administration of naloxone
(B) Administration of physostigmine
(C) Induction of general anesthesia
(D) Determination of serum electrolyte concentrations
A woman is in labor at 40 weeks' gestation and the fetus is in breech presentation. Which of the following will provide adequate uterine relaxation for vaginal delivery?
Appropriate anesthetic management of a patient with hypertrophic cardiomyopathy includes each of the following EXCEPT
(A) maintaining normal or slightly greater than normal preload
(B) adjusting positive airway pressure to maintain near normal venous return
(C) preference for volatile agents rather than opiates for anesthesia
(D) use of beta-adrenergic blocking agents to increase ventricular wall compliance
(E) decreasing afterload with peripheral vasodilators
E
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