Immediate Postoperative Care Flashcards
7 cards from real CCTC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Immediate Postoperative Care flashcards as text
A kidney transplant recipient in the ICU has urine output of 800 mL/hr in the first postoperative hour. What is the most appropriate initial management?
Answer: Replace urine output mL-for-mL with IV fluids
Brisk diuresis after kidney transplant requires mL-for-mL fluid replacement to maintain adequate perfusion and prevent dehydration.
Which electrolyte abnormality is most commonly associated with a large diuresis in the immediate post-kidney transplant period?
Answer: Hypokalemia
Hypokalemia is common after large diuresis as potassium is lost in high urine volumes, requiring monitoring and replacement.
A liver transplant patient develops a sudden decrease in bile output from the T-tube on postoperative day 1. What should the transplant coordinator suspect first?
Answer: Hepatic artery thrombosis
Hepatic artery thrombosis causes sudden cessation of bile production and is the most feared early complication after liver transplant.
What is the target mean arterial pressure (MAP) goal typically maintained in the immediate post-transplant ICU period?
Answer: Above 65 mmHg
A MAP above 65 mmHg is the standard target to ensure adequate perfusion pressure to the transplanted organ.
A heart transplant recipient is noted to have a heart rate of 48 bpm on postoperative day 1. Which medication is used to increase heart rate in the denervated transplanted heart?
Answer: Isoproterenol
The denervated transplanted heart does not respond to atropine; isoproterenol acts directly on beta-1 receptors and is the drug of choice.
In the immediate postoperative period, which immunosuppressive agent is most commonly associated with nephrotoxicity?
Answer: Calcineurin inhibitors (tacrolimus/cyclosporine)
Calcineurin inhibitors cause afferent arteriolar vasoconstriction leading to nephrotoxicity, which must be monitored closely post-transplant.
A lung transplant patient develops increasing hypoxia with bilateral infiltrates on CXR within 72 hours of transplant. What is the most likely diagnosis?
Answer: Primary graft dysfunction (PGD)
Primary graft dysfunction presents within 72 hours with hypoxia and bilateral infiltrates from ischemia-reperfusion injury to the donor lung.