problems in postop patients?
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Statins
,Which systematic complications are associated with peripheral thrombolectomy?
A. Vasospasm, bleeding, hematoma formation, compartment syndrome
B. Renal failure, rhabdomyolysis, vasospasm, hemorrhage
C. Edema, hyperkalemia, cardiac arrhythmia, renal failure, rhabdomyolysis
D. Vasospasm, thrombus formation, artery dissection, compartment syndrome
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C
Complications associated with peripheral thrombolectomy include
thrombus formation, vessel vasospasm, bleeding, hematoma formation,
artery dissection, compartment syndrome, venous thrombosis, edema,
hyperkalemia, cardiac arrhythmia, renal failure, and rhabdomyolysis.
Following repair for aortic reguritation, what is the most common
condition/complication he nurse should be observant for?
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Poor contractility. Postoperatively, because patients have dilated ventricles
from the aortic regurgitation and its associated aortic insufficiency, they
may require administration of intravenous vasodilators. Agents such as
milrinone (Primacor®) and dobutamine (Dobutrex®) may be indicated for
inotropic support and to promote ventricular emptying.
The following hemodynamic profile is noted upon admission in a postoperative CABG
patient: BP, 91/38 mm Hg; mean arterial pressure (MAP), 58 mm Hg; HR, 108/min; core
temperature, 36.5°C; pulmonary arterial pressure (PAP), 20/12 mm Hg; CVP, 6 mm Hg;
, SvO2, 59%; cardiac output, 3.6 L/min; cardiac index, 1.8; systemic vascular resistance,
1006 dyne ⋅ sec ⋅ cm−5; stroke volume, 33 mL; pulse oximetry (SpO2), 93% saturation;
urine and chest tube output both 100 mL in the past hour; and hemoglobin level is 10
g/dL. The nurse should first do which of the following?
A. Continue with admission procedure (catheters, chest radiographs, laboratory
values)—no treatment needed at this point
B. Administer fluid because the patient is hypovolemic
C. Administer calcium chloride to increase contractility
D. Start dopamine to increase BP and contractility
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B
Hypovolemia is noted by the low stroke volume, low CVP, and low
pulmonary artery diastolic pressure, cardiac output, and cardiac index. The
CVP and pulmonary artery diastolic pressure would be high if the patient
needed an intervention to increase contractility.
An obese 70-year-old man with a history of atrial fibrillation is recovering from open-
heart surgery for aortic valve replacement. To decrease the risk of developing
postoperative atrial fibrillation, which of the following medications is most commonly
administered for prophylaxis?
A. Metoprolol or atenolol
B. Amiodarone
C. Sotalol
D. Magnesium sulfate
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A
Low-dose beta-blockers, such as metoprolol (25-50 mg twice daily) or
atenolol (25 mg daily), are the most common drugs to prevent atrial
fibrillation (Afib), decreasing the incidence of Afib by up to 65%. Atrial
flutter (> 380 bpm) and Afib (> 380 bpm) occur in up to 30% of patients with
open heart surgery. Risk factors include obesity, chronic obstructive
pulmonary disease, valve surgery, and a history of Afib. Amiodarone is