CCTC Immediate Postoperative Care 2

Question 1

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?

Accepted Answer

Replace urine output mL-for-mL with IV fluids

Answer

Brisk diuresis after kidney transplant requires mL-for-mL fluid replacement to maintain adequate perfusion and prevent dehydration.

Question 2

Which electrolyte abnormality is most commonly associated with a large diuresis in the immediate post-kidney transplant period?

Accepted Answer

Hypokalemia

Answer

Hypokalemia is common after large diuresis as potassium is lost in high urine volumes, requiring monitoring and replacement.

Question 3

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?

Accepted Answer

Hepatic artery thrombosis

Answer

Hepatic artery thrombosis causes sudden cessation of bile production and is the most feared early complication after liver transplant.

Question 4

What is the target mean arterial pressure (MAP) goal typically maintained in the immediate post-transplant ICU period?

Accepted Answer

Above 65 mmHg

Answer

A MAP above 65 mmHg is the standard target to ensure adequate perfusion pressure to the transplanted organ.

Question 5

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?

Accepted Answer

Isoproterenol

Answer

The denervated transplanted heart does not respond to atropine; isoproterenol acts directly on beta-1 receptors and is the drug of choice.

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC - Certified Clinical Transplant Coordinator Practice Test

CCTC Immediate Postoperative Care 2