Post Op and PACU Flashcards
Unit that provides care while patient recovers from anesthesia
PACU- Post Anesthesia Care Unit
Their role is to protect/ maintain patient’s airway
Anesthesiologist/ CRNA
WHo is responsible for giving report to PACU nurse post op?
Anesthesiologist and circulating nurse
immediate recovery phase where intensive nursing care is provided.
Phase 1 PACU
phase where the patient is prepared for transfer to an inpatient nursing unit, an extended care setting, or discharge.
Phase 2 PACU
WHat should be the focus and considered any time a patient is transported or moved?
The incision site
Report to PACU nurse includes
Surgery performed/ Dx
Anesthesia Used
Meds & Time Given
Amount of Blood Loss
If Pt Intubated
Any Surgical Complications that occurred
MD orders
Vital Signs
scoring system that helps determine when a patient can be safely discharged from the post-anesthesia care unit (PACU)
Andrete Score
Pt must score 7-10 to be discharged from PACU
What to assess in PACU?
Frequent vital signs (at least q15 or less)
EKG- continuous
Pulse Ox- Continuous
Standard VS q15
Frequent VS spot hemodynamic changed quickly
low amount of oxygen in tissues
hypoxia
Why is inspection important during PACU assessement?
Assessing surgical dressings for bleeding
Assessing IV lines to ensure the lines are intact, infused and no infiltration (swelling)
Common PACU complications
Hypotension
Hypertension
Shock
Hemorrhage
Dysrhythmia
Primary pt focus in post op setting is
MAINTAINING PT AIRWAY
Maintaining pt airway prevents
hypoxemia and hypercapnia
low oxygen levels in the blood
hypoxemia
increased CO2 in blood
hypercapnia
What can occur if airway is blocked?
Hypoxemia and hypercapnia
blockage in the lower throat that can cause breathing problems’ tongue falls back and occludes airway; patient is lacking oxygen
Hypopharangeal Obstruction
S&S of hypopharangeal obstruction
choking
noisy, irregular respirations
low pulse ox
cyanosis of skin
Treatment for Hypo pharangeal obstruction
Tilting head back and chin lift
handheld tool that delivers positive air pressure ventilation to any subject with insufficient breaths
AMBU Bag
can results from blood loss, hypoventilation, position changes, pooling of blood in the extremities ; could be from side effects of meds or anesthesia
Shock & Hypotension
Most common cause of shock/hypotension
Blood loss greater than 500 cc’s
For blood loss — for every 1 cc of blood loss …
give 3 cc’s of IV solutions (until blood is available) *no need for MD order *
Common IV fluids that can supplement instances of blood loss
Lactated Ringers
Normal Saline
isotonic solutions
Blood pressure reportable to MD in post op setting due to inadequate perfusion
Systolic BP of 90 or less
