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
Which immunosuppressive drug used in the immediate post-transplant period is most associated with hyperglycemia requiring insulin therapy?
Answer: Tacrolimus and corticosteroids
Tacrolimus impairs insulin secretion from beta cells, and corticosteroids cause insulin resistance, together producing significant post-transplant hyperglycemia.
A kidney transplant patient's morning labs show a tacrolimus trough level of 24 ng/mL (target 8-12 ng/mL). What is the most appropriate action?
Answer: Hold next dose and notify the transplant physician
A supratherapeutic tacrolimus level increases nephrotoxicity and neurotoxicity risk; the dose should be held and the physician notified for dose adjustment.
What is the significance of pink or red-tinged drain output following a liver transplant in the immediate postoperative period?
Answer: Possible arterial or venous bleeding requiring immediate assessment
Bloody drain output suggests intraabdominal hemorrhage, which is a surgical emergency requiring urgent evaluation and possible re-exploration.
In the immediate postoperative period after heart transplant, pulmonary hypertension in the recipient increases the risk of which complication?
Answer: Right ventricular failure of the donor heart
The donor right ventricle is unaccustomed to high pulmonary pressures in the recipient and can fail acutely when exposed to pre-existing pulmonary hypertension.
A nurse reports that a post-renal transplant patient has not produced any urine for 2 hours. After ruling out catheter obstruction, what is the next step?
Answer: Administer a fluid bolus and reassess
A fluid bolus is the first step to optimize intravascular volume and perfusion before escalating to other interventions for post-transplant oliguria.
Which post-transplant complication is characterized by the triad of hypertension, edema, and proteinuria occurring early after transplant?
Answer: Thrombotic microangiopathy (TMA) related to calcineurin inhibitors
TMA can occur as a complication of calcineurin inhibitors, presenting with hypertension, edema, and proteinuria from endothelial injury to glomerular capillaries.
When assessing pain in an immediate post-transplant patient who cannot self-report, which validated tool is most appropriate?
Answer: Behavioral Pain Scale (BPS) or CPOT
The Behavioral Pain Scale (BPS) and Critical Care Pain Observation Tool (CPOT) are validated for assessing pain in non-verbal ICU patients based on behavioral indicators.