MCAT Question #43

I cannot reveal my source, but I once again am privy to esoteric wisdom. The following is a question I have obtained from the Medical College Admission Exam (MCAT):

You are a surgeon and you performed an outpatient procedure on Jane Patient. During the procedure the anesthesiologist gives 1800cc of fluid to hydrate the patient.  Two hours after the surgery the patient is AAOX3 and ready to go home.  But the nurse calls you saying the patient's SPO2 is only 84% on room air.  On 2lpm her SpO2 is 90%.  You order for RT to do an ABG on room air that shows the following results:  pH 7.33, CO2 33, PO2 50.  You order an EKG and an x-ray.  The EKG shows normal and the x-ray shows new onset infiltrates in the bases.  Which of the following would be the most appropriate next action?

• a.  Think fluid overload and order 40mg of Furosimide followed by an ABG 30 minutes later
• b.  Think cardiac and order a second EKG
• c.  Think bronchospasm and order 2.5mg of Albuterol nebulizer followed by an ABG 30 minutes later
• d.  Send the patient home.  She's fine.