During use of the ventilator on an anesthesia machine, positive pressure is noted on the airway pressure gauge during exhalation. Positive end-expiratory pressure has not been purposefully added to the breathing circuit. Which of the following is the most likely cause?
A 32-year-old patient with end-stage renal failure has irreversible neuromuscular blockade two hours after tracheal intubation with a muscle relaxant. Which of the following is the most likely cause?
Bupivacaine is more likely than lidocaine to cause refractory cardiac arrest because bupivacaine
A 68-year-old woman who is receiving urokinase for deep venous thrombosis and pulmonary emboli requires emergency laparotomy for a bleeding gastric ulcer. Which of the following agents is most appropriate to reverse the effects of urokinase?
An increased initial dose and a decreased maintenance dose of pancuronium are required in patients with
Which of the following physiologic changes occurs with immersion in water during extracorporeal shock wave lithotripsy?
During carotid endarterectomy, blood pressure suddenly decreases from 140/90 to 80/50 mmHg. The EKG shows a heart rate of 42 bpm, with normal sinus rhythm and occasional premature ventricular contractions. The most appropriate therapy is intravenous administration of
A 95-kg, 65-year-old woman receives sevoflurane and pancuronium during a laparoscopic cholecystectomy. Three minutes after administration of neostigmine 5 mg and atropine 1.2 mg, the twitch height returns to normal. Spontaneous tidal volume is 500 ml when the endotracheal tube is removed. In the PACU she reports dyspnea and appears distressed. Which of the following is the most likely cause of the respiratory distress?
Two days after myocardial infarction involving the left anterior descending coronary artery, a patient's blood pressure decreases acutely from 125/80 to 70/40 mmHg, heart rate increases from 75 to 90 bpm, pulmonary artery pressure increases to 50/30 mmHg, and urine output decreases from 60 to 10 ml/hr. Thermodilution cardiac output has increased from 4 to 7 L/min. The most appropriate action is to
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?