At the time of cesarean delivery, thick dark meconium is noted and the newborn is flaccid, apneic, bradycardic, and cyanotic. The most appropriate initial action is
A 62-year-old man with severe emphysema was treated for the sixth time with assisted mechanical ventilation (Fi02 0.6, peak inspiratory pressure 25 mmHg, rate 22/min, insp/exp 0.3). Arterial blood gas values with this therapy are Pa02 73 mmHg, PaC02 48 mmHg, and pH 7.32. During the second day of treatment he suddenly becomes dusky, with increased respiratory rate. Arterial blood gas values are Pa02 42 mmHg, PaC02 67 mmHg, and pH 7.25. Tracheal lavage and suction fail to improve his condition. The therapeutic measure most likely to correct this acute episode is to
(A) administer heparin
(B) increase Fi02
(C) paralyze him with pancuronium
(D) add positive end-expiratory pressure 5 to 10 cmH20
(E) insert a chest tube
E
A 19-year-old woman receives a spinal anesthetic for a repeat cesarean delivery. Two days later she is afebrile but has severe occipital pain that is aggravated by sitting or standing and relieved by lying flat. Associated findings would likely include
A 45-year-old man is scheduled for exploratory laparotomy. Six months ago, he received doxorubicin (Adriamycin) therapy for testicular cancer. This patient is at increased risk for
A 16-year-old child has an arterial catheter inserted prior to a potentially difficult intubation for a craniofacial operation. While awake and breathing room air, arterial blood gas values are: PaO2 134 mm Hg, PaCO2 28 mm Hg, and pH 7.45. These values can be explained by
(A) excess heparin mixed with the arterial sample
(B) a patient core temperature of 38°C
(C) excess air entrained in the syringe during sampling
(D) storing the sample at room temperature for 15 minutes before processing