A patient is recovering from surgery to clip an aneurysm. Which of the following interventions will prevent cerebral vasospasm in this patient?
1. dehydration
2. diuretic therapy
3. triple H therapy
4. infusion of packed red blood cells
3
Rationale: Postoperative complications associated with the clipping of an aneurysm include cerebral vasospasm. Vasospasm decreases perfusion to brain tissue and is prevented and treated with "triple H therapy": hypervolemia, hypertension, and hemodilution. This combination of therapies is used to augment cerebral perfusion pressure by raising systolic blood pressure, cardiac output, and intravascular volume to increase cerebral blood flow and minimize cerebral ischemia. Triple H therapy is maintained for the first 2-3 days postoperatively. Dehydration will not support cerebral perfusion. Diuretic therapy also will not support cerebral perfusion; there is no evidence to suggest that the patient needs an infusion of packed red blood cells.
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1. "Yes, all sexually active females should be screened for both cervical cancer and HPV." 2. "No, you do not need to be screened for cervical cancer until you are 21 years old." 3. "Yes, all women under the age of 29 should be screened for both cervical cancer and HPV." 4. "No, but you will need to begin your screenings for both cervical cancer and HPV when you are 18 years old."