Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What medication administered during surgery might lead to postoperative hypertension in a patient after an ethmoidectomy?

1. Cocaine

2. Droperidol

3. Ondansetron

4. Desflurane

The correct answer is: Cocaine

Cocaine is recognized for its vasoconstrictive properties, and when used as a local anesthetic, particularly in nasal surgeries like an ethmoidectomy, it can lead to significant hypertension postoperatively. This effect occurs because cocaine stimulates the sympathetic nervous system, leading to increased heart rate and blood pressure. In contrast, droperidol, which is an antipsychotic with antiemetic properties, generally works by causing peripheral vasodilation and may not be associated with an increase in blood pressure. Ondansetron, a common antiemetic used to prevent nausea and vomiting after surgery, does not influence blood pressure significantly and is primarily focused on serotonin receptor antagonism. Desflurane, a volatile anesthetic, can affect cardiovascular stability, but its association with hypertension is less pronounced compared to cocaine. Thus, the use of cocaine in surgical settings, particularly in procedures involving the nasal cavity, warrants careful monitoring due to its potential to provoke postoperative hypertension.