l******g
发帖数: 278 | 1 Six hours after undergoing surgical excision of the distal colon for
cancer, a 77-year-old man has decreased urine output. His urine output has
been 10 mL/h during the past 3 hours. During the 4-hour operation, he lost
500 mL of blood and underwent transfusion of 1 unit of packed red blood
cells. His initial postoperative course was uncomplicated. Two years ago, he
had a myocardial infarction and underwent coronary artery bypass grafting.
He has a 10-year history of hypertension well controlled with atenolol.
Current medications include morphine and labetalol. He currently appears
pale and diaphoretic. His temperature is 37°C (98.6°F), pulse is 85/min,
respirations are 14/min, and blood pressure is 90/60 mm Hg. Pulse oximetry
on 2 L/min of oxygen via nasal cannula shows an oxygen saturation of 89%.
Cardiopulmonary examination shows no abnormalities. The abdomen is
nondistended with mild tenderness over the incision. His hematocrit is 24%,
serum sodium concentration is 140 mEq/L, and serum creatinine concentration
is 2.1 mg/dL. The patient is switched to administration of 100% oxygen by a
nonrebreathing face mask. The most appropriate next step in management is
administration of which of the following?
A
) Bumetanide
B
) 5% Dextrose in water
C
) Fresh frozen plasma
D
) Furosemide
E
) Packed red blood cells
F
) 0.45% Saline | q**d
发帖数: 109 | | z**********4
发帖数: 467 | | s*********e
发帖数: 116 | | l*******d
发帖数: 449 | 5 E His hematocrit is 24% , to avoid cardiac ischemia, the HCT should be
higher than 30% |
|
