1. A 48-year-old female wt 70 kg, is in the ICU with acute pancreatitis. Her vital signs are

as follows: BP 92/60 mm Hg; heart rate 116 bpm; She is intubated with current ventilator

settings of VT 700 mL, assist control (AC) rate 12 bpm, FiO2 0.85, and positive end

expiratory pressure (PEEP) 5.0 cm H2O. Her ABG reveals a pH of 7.31, PaCO2 of 53

mm Hg, and a PaO2 of 62 mm Hg. Her chest radiograph shows diffuse, fluffy infiltrates.

Based upon this assessment the ACNP change to SIMV

2. . A 50-year-old woman presents to your office complaining of lower extremity edema

that stated several weeks ago, and slowly progressed thereafter. Her past medical history

is significant for hypertension, treated with metoprolol for 2 years. Amlodipine was

added recently because of inadequate control of BP with metoprolol alone. She does not

smoke or consume alcohol. She has no known drug allergies. Her blood pressure is

130/80mm Hg and her heart rate is 64/min. The physical examination reveals bilateral

symmetric 3+ pitting edema of both lower extremities, without any skin changes or

varicosities Her neck vein pulsation is normal. Other physical findings are within normal

limits. Her laboratory studies reveal the following Serum albumin 4.5 g/dL Total serum

bilirubin 0.8 mg/dL Serum sodium 140 mEq/L Serum potassium 4.0 mEq/L Serum

creatinine 0.8 mg/dL Urinalysis is within normal limite. What is the most likely cause of

the edema in this patient? Heart failure