Progressive Care Nursing Certification (PCCN) Practice Exam

A 68-year-old male is post-operative after coronary angioplasty and presents with flank pain and hypotension. What is the most appropriate nursing action?

1. Keep the head of the bed flat and apply pressure at the sheath site.

2. Notify a physician immediately and anticipate ultrasound-guided compression.

3. Notify a physician immediately, and anticipate anticoagulation therapy.

4. Notify a physician and anticipate IV fluid and/or blood administration.

The correct answer is: Notify a physician and anticipate IV fluid and/or blood administration.

The situation indicates that the patient is experiencing flank pain and hypotension following a coronary angioplasty, which raises the suspicion of potential complications such as bleeding or a hematoma at the catheterization site. In this scenario, notifying the physician promptly is crucial due to the patient's unstable condition. Administering IV fluids and/or blood is essential for managing hypotension, which may be due to intravascular volume depletion from bleeding. Supporting the patient's hemodynamic status by correcting fluid loss can help stabilize blood pressure and improve perfusion until further assessments and interventions can be conducted. While other options might also be relevant in different contexts, the priority should focus on addressing the immediate effects of hypotension first. Therefore, initiating IV fluids and potentially blood products aligns with the urgent need to maintain hemodynamic stability, indicating a clear, appropriate nursing action in this critical situation.