A previously healthy 28-year-old man is admitted to the emergency department with a probable opioid overdose. Arterial blood gas values are: PaO2 49 mmHg, PaCO2 76 mmHg, and pH 7.12 while breathing room air. Which of the following statements is true?
(A) Aspiration of gastric contents must have occurred
(B) Hypoventilation alone can explain the acidosis and hypoxemia
(C) The hypoxemia is probably due to noncardiogenic pulmonary edema
(D) Naloxone should be administered only if the patient is normothermic
A 2600-g neonate is to undergo surgical repair of a small gastroschisis. The infant is preoxygenated with 100% oxygen. Arterial hemoglobin desaturation is noted during laryngoscopy after a rapid-sequence induction. Which of the following is the most likely cause?
(A) High fetal hemoglobin concentration
(B) High ratio of oxygen consumption to functional residual capacity
(C) Low functional residual capacity in milliliters per kilogram
During frontal craniotomy for removal of an astrocytoma, the surgeon notes that the brain is "tight." The patient is receiving nitrous oxide 50% in oxygen, isoflurane 0.5%, fentanyl, and pancuronium. Heart rate is 92 bpm, blood pressure is 110/60 mmHg, end-tidal carbon dioxide tension is 31 mmHg, and oxygen saturation is 98%. The most appropriate initial treatment is to
(A) administer a beta-adrenergic blocker
(B) administer thiopental
(C) decrease isoflurane concentration
(D) decrease mean arterial pressure to 60 mmHg
(E) increase alveolar ventilation
E
A 24-year-old man is undergoing induction of general anesthesia prior to appendectomy. During laryngoscopy, he regurgitates a large amount of bilious material. An endotracheal tube is inserted; aspiration shows bile-stained fluid. Which of the following is the most appropriate next step in management?
(A) Infusion of a loading dose of aminophylline
(B) Intravenous administration of broad-spectrum antibiotics
(C) Lavage of the tracheobronchial tree with saline solution