Progressive Care Nursing Certification (PCCN) Practice Exam

What condition should a nurse monitor for in patients with a history of hypertension undergoing surgical procedures?

1. Post-operative anemia

2. Electrolyte imbalance

3. Development of delirium

4. Pulmonary edema

The correct answer is: Development of delirium

Monitoring for the development of delirium in patients with a history of hypertension undergoing surgical procedures is essential due to several interconnected factors. Hypertension can lead to chronic changes in the brain's vascular structures, increasing the risk for cognitive disturbances postoperatively. Additionally, surgical stress, anesthesia, and potential fluid shifts can further exacerbate the vulnerability of these patients to delirium. Delirium is characterized by an acute onset of confusion and altered mental status, and it can significantly impact recovery and outcomes. Patients with pre-existing hypertension may have underlying vascular issues or cognitive impairments that can predispose them to this condition after experiencing the stress of surgery. Moreover, postoperative factors such as pain, medication effects, sleep disruption, and changes in metabolic status can all contribute to the risk of delirium in these patients, making close monitoring vital. Addressing and preventing delirium is crucial, as it can lead to longer hospital stays and greater overall morbidity. In contrast, while post-operative anemia, electrolyte imbalance, and pulmonary edema are important considerations in the care of surgical patients, they are not as directly associated with the effects of hypertension and the acute changes induced by surgery as delirium is. Thus, focusing on delirium allows for better tailored interventions and monitoring strategies to ensure