Adult Critical Care Specialty (ACCS) Practice Exam

In terms of immediate post-operative care for valve replacement, what is crucial to monitor closely?

1. Fluid intake

2. Blood pressure

3. Temperature

4. Urine output

The correct answer is: Blood pressure

Monitoring blood pressure closely in the immediate post-operative care for valve replacement is crucial due to several reasons. First, patients who have undergone valve replacement surgery are at increased risk for hemodynamic instability immediately after the procedure. The operation can significantly affect cardiac output and overall vascular dynamics, and any abrupt changes in blood pressure may indicate complications such as bleeding, cardiac tamponade, or other forms of shock. Furthermore, maintaining adequate blood pressure is essential to ensure that the newly replaced valve is functioning correctly and that the heart can adequately perfuse vital organs. Hypotension, for example, could lead to inadequate organ perfusion, while hypertension could stress the surgical site and potentially cause complications such as bleeding or graft failure. While fluid intake, temperature, and urine output are also important parameters to monitor in post-operative care, they are often secondary to blood pressure. Fluid intake is significant for assessing hydration and fluid balance, but if blood pressure drops, interventions may prioritize stabilizing the hemodynamic status first. Similarly, while tracking temperature is important to identify potential infections, it is usually not as immediate a concern as blood pressure changes right after surgery. Finally, urine output is an indicator of kidney perfusion and can provide information on fluid balance and function, but abnormal output