A 62-Year-Old Man Undergoes a Partial Pancreatectomy for Exocrine Pancreatic

question 384

Multiple Choice

A 62-year-old man undergoes a partial pancreatectomy for exocrine pancreatic cancer.  The surgery is complicated by excessive peripancreatic bleeding requiring careful surgical hemostasis.  The patient receives packed red blood cell transfusion during the surgery as well as intravenous normal saline.  He is transferred to the surgical intensive care unit for close monitoring and is successfully extubated.  Twelve hours later, the nurse reports decreased oxygen saturation.  The patient has received multiple doses of morphine for pain control since the surgery.  Temperature is 37.5 C (99.5 F) , blood pressure is 80/40 mm Hg, pulse is 112/min, and respirations are 28/min.  The patient's pulse oximetry shows 87% on 4 L nasal cannula oxygen.  Examination reveals bilateral basal crackles.  The abdomen is mildly distended and tender, and bowel sounds are decreased.  There is no rebound tenderness or rigidity.  Pulmonary artery catheter readings show a cardiac index of 2 L/min/m² (normal, 2.8-4.2) and a pulmonary capillary wedge pressure of 20 mm Hg (normal, 6-15) .  Which of the following is the most likely etiology of this patient's current condition?

• A)Acute pancreatitis
• B)Adrenal crisis
• C)Myocardial infarction
• D)Pulmonary embolism
• E)Retroperitoneal hemorrhage
• F)Transfusion-related acute lung injury

---

Definitions:

Conflicts

Situations or internal states where incompatible objectives, beliefs, or behaviors lead to a state of tension.

Developmental Stages

Represent phases in human growth and development characterized by distinct physical, cognitive, and emotional changes that occur in a predictable sequence.

Social Forces

The societal structures, cultural norms, and institutions that influence individual behaviors, actions, and interactions.

Biological Forces

Natural and inherent influences on human behavior and development, including genetics and physiological processes.