Progressive Care Nursing Certification (PCCN) Practice Exam

What medications would a nurse anticipate administering to a patient with an acute Type III aortic dissection for blood pressure control?

1. digoxin (Lanoxin) and furosemide (Lasix)

2. metoprolol (Lopressor) and lisinopril (Prinivil)

3. furosemide and spironolactone (Aldactone)

4. bumetanide (Bumex) and amlodipine (Norvasc)

The correct answer is: metoprolol (Lopressor) and lisinopril (Prinivil)

In the management of an acute Type III aortic dissection, controlling blood pressure is critical to prevent further complications and stabilize the patient's condition. The appropriate choice for blood pressure management involves medications that can effectively reduce heart rate and vascular resistance. Metoprolol, a beta-blocker, is beneficial in reducing heart rate and myocardial contractility, which decreases the workload on the heart and helps lower blood pressure. This effect is essential in aortic dissection as it can help reduce the shear stress on the aortic wall, decreasing the risk of further dissection or rupture. Lisinopril, an ACE inhibitor, further complements this treatment approach by providing vasodilation effects, which helps to reduce systemic vascular resistance and lower blood pressure without causing reflex tachycardia. This medication also offers renal protective properties and is important in managing hypertensive emergencies. In summary, the combination of metoprolol and lisinopril provides both heart rate control and afterload reduction, making it the most suitable choice for blood pressure control in a patient with acute Type III aortic dissection. This approach focuses on both immediate stabilization and long-term management of blood pressure to minimize the risks associated with this life-threatening condition.