PACU Care Complications

Question 1

At what temperature when patient is considered hypothermic (PACU care complications)?

Answer 1

Temp < 36 C

Question 2

What are complications associated with hypothermia?

Answer 2

Shivering
Impaired wound healing/ surgical infection site
Myocardial ischemia
Coagulopathy

Question 3

What is the treatment for hypothermia?

Answer 3

Warming measures checked Q15 minutes

Question 4

What are the risk factors for PONV (PACU care complications)?

Answer 4

Female +1
Nonsmoker +1
PONV Hx +1
Postoperative opioids +1

Question 5

What is the difference between Reglan and Zofran (PACU care complications)?

Answer 5

!Reglan - MOA is increasing gastric emptying
!Reglan contraindicated patient’s with Parkinsons because it blocks dopamine receptors
!Zofran - given after chemotherapy or surgery
Zofran - 5-HT3 receptor antagonists, MOA blocking the action of serotonin, a natural substance that may cause nausea and vomiting

Question 6

What is emergence delirium (PACU care complications)?

Answer 6

Dissociative state of consciousness demonstrated by responsive/ non-responsive agitation that may last 10-45 minutes
Anxiety and Agitation

Question 7

What is the treatment for emergence delirium (PACU care complications)?

Answer 7

Keep safe
!Always rule out hypoxemia

Question 8

How does succinylcholine help in laryngospasm (PACU care complications)?

Answer 8

Relax laryngeal muscles

Question 9

How does steroids/ lidocaine IV help in laryngospasm (PACU care complications)?

Answer 9

Decrease airway irritation - racenic epinephrine

Question 10

What are the causes of dilutional hyponatremia in TURP syndrome (PACU care complications)?

Answer 10

Absorption of irrigating solutions
!Leads to water intoxication

Question 11

What are the s/s of dilutional hyponatremia (PACU care complications)?

Answer 11

Confusion
Nausea
Bradycardia
Seizure
Coma

Question 12

What are the characteristics of compartment syndrome (PACU care complications)?

Answer 12

5 P’s
Pallor
Paresthesia
Paralysis
Pulselessness
Pressure

Question 13

What are the s/s of compartment syndrome (PACU care complications)?

Answer 13

Severe pain not relieved by analgesics

Question 14

What is the late sign for MH (PACU care complications)?

Answer 14

Fever

Question 15

What BP medication can not be given to MH (PACU care complications)?

Answer 15

!No calcium channel blockers for MH

Question 16

What is citrate toxicity in blood transfusion (PACU care complications)?

Answer 16

Per NIH, citrate toxicity occurs when citrate in transfused blood begins to bind calcium in the patient’s body. However, clinically significant hypocalcemia does not usually occur unless the rate of transfusion exceeds one unit every five minutes or so.

Question 17

What is the treatment for Disseminated Intravascular Coagulation (PACU care complications)?

Answer 17

Fresh frozen Plasma when bleeding is present or anticipated

Question 18

What medication to treat Von Willebrand Disease (coagulation/ bleeding d/o)?

Answer 18

DDVAP - prevents breakdown of clotting factors

Question 19

What are the side effects of scopolamine (PACU care complications)?

Answer 19

!Disorientation
!Hallucinations
Sedation
Dry mouth
Visual disturbance
Dysphoria
Confusion