A 54-Year-Old Man with a 30-Pack-Year Smoking History Undergoes Laparoscopic

question 544

Multiple Choice

A 54-year-old man with a 30-pack-year smoking history undergoes laparoscopic cholecystectomy after an episode of biliary pancreatitis.  On the third postoperative day, he is found to be mildly hypoxemic at 90% on room air.  His temperature is 36.7° C (98° F) , blood pressure is 130/80 mm Hg, heart rate is 90/min, and respirations are 22/min.  Lung auscultation shows decreased breath sounds at the bases.  Arterial blood gas analysis results are as follows: Which of the following most likely explains the observed findings?

• A)Aspiration of gastric secretions
• B)Bronchial wall edema and bronchospasm
• C)Diaphragmatic paralysis
• D)Impaired cough and shallow breathing
• E)Ventilator-associated pneumonia

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