During a right lower lobe resection, SpO2 decreases from 99% to 70% after institution of one-lung ventilation. FiO2 is 1.0. The most appropriate management is to
(A) administer an inhaled bronchodilator
(B) apply continuous positive airway pressure to the right lung
(C) apply positive end-expiratory pressure to the left lung
During induction of general anesthesia in a patient with a supraglottic tumor, both intubation and subsequent ventilation via a face mask are impossible. A cricothyroidotomy is performed with a 16-gauge intravenous catheter. Which of the following statements is true?
(A) Application of pressures greater than 35 cmH2O to the catheter will increase the risk for pulmonary barotrauma
(B) PaC02 can be maintained at a normal level using a standard circle system attached to the catheter
(C) PaO2 greater than 100 mmHg can be maintained indefinitely using transtracheal jet ventilation with pure oxygen through the catheter
(D) Emergency surgical tracheostomy would have improved the likelihood of survival
(E) The presence of this tumor contraindicates jet ventilation via cricothyroidotomy
In a patient who is breathing spontaneously, the work of breathing increases with each of the following EXCEPT
(A) decreased compliance
(B) decreased vital capacity
(C) increased carbon dioxide production
(D) increased respiratory rate
(E) increased dead space
B
A 40-year-old woman receives alfentanil 75 mcg/kg followed by an infusion of 1.5 mcg/kg/min for a one-hour cholecystectomy and cholangiogram. This regimen could be associated with each of the following EXCEPT
During isoflurane anesthesia, a 45-year-old patient with chronic asthma has wheezing, prolonged expiration, sinus tachycardia of 120 bpm, and premature ventricular contractions. Preoperative medication included cromolyn and theophylline. The most appropriate treatment is to administer
A 52-year-old woman undergoes facial surgery during general endotracheal anesthesia. The ventilator is set to deliver a tidal volume of 600 ml and a respiratory rate of 10/min at an FiO2 of 1.0. SpO2 is 100%, peak inspiratory pressure is 18 cmH2O, and PetCO2 is 40 mmHg. The surgeon flexes the patient's head so the chin touches the chest. Which of the following findings indicates that endobronchial intubation has NOT occurred?
(A) Fluctuating capnographic waveform
(B) Greater expiratory volume than inspiratory volume
A patient is undergoing cholecystectomy with enflurane, nitrous oxide, fentanyl, and oxygen. He takes theophylline and cromolyn sodium for bronchial asthma. During skin incision he has bilateral wheezing; peak inspiratory pressure is 50 cmHzO, and the ECG shows occasional premature ventricular contractions. The most appropriate management is to
(A) switch from enflurane to isoflurane
(B) administer lidocaine intravenously
(C) administer methylprednisolone intravenously
(D) administer nebulized cromolyn sodium
(E) administer nebulized metaproterenol
E
A burn is found at the site of the electrocautery pad. Which of the following is most likely?
(A) The electrosurgical unit was in the bipolar mode
(B) The electrocautery pad became partially detached
(C) The electrosurgical unit ground wire was severed