Adult Critical Care Specialty (ACCS) Practice Exam

After aortic valve replacement, what intervention is recommended for a patient with rising blood pressure?

1. Administer antihypertensive

2. Fluid bolus

3. Anticoagulation

4. Intubation and mechanical ventilation

The correct answer is: Administer antihypertensive

In the context of a patient recovering from aortic valve replacement, rising blood pressure can indicate several potential complications, including improper fluid management or increased systemic vascular resistance. Administering antihypertensive medication is a key intervention in this scenario because it directly addresses the elevated blood pressure and helps maintain hemodynamic stability after surgery. Controlling blood pressure is critical in a postoperative setting, especially following cardiac surgery. It is important to avoid excessive afterload, which can strain the newly replaced valve and the heart, potentially leading to adverse outcomes such as myocardial ischemia or left ventricular overload. By administering antihypertensive medication, the healthcare team can actively manage the patient's blood pressure to ensure proper cardiac function and recovery. While other interventions such as fluid bolus or anticoagulation could be considered based on specific clinical indications, they do not directly target the immediate concern of hypertension in this context. Intubation and mechanical ventilation would be reserved for patients experiencing severe respiratory distress or failure, which is not indicated solely by rising blood pressure. Thus, selecting the administration of antihypertensive agents is a focused and appropriate response to the complication of elevated blood pressure after aortic valve replacement.