POSTOPERATIVE

Question 1

What is the goal PACU (5)

Answer 1

1 maintain client safety
2 adequate body system
3 alleviate pain
4 prevent post complications
5 identify actual and potential problems

Question 2

vital roles of nursing (5)

Answer 2

1 support ventilation & perfusion
2 maintain fluid and electrolyte balance
3 promoting comfort
4 reducing infection
5 promoting safety

Question 3

immediate assessment includes (3)

Answer 3

1 proper positioning to promote airway
patency
2 supporting vital physiologic functions
3 immediate assessment

Question 4

what do the nurse need to check for airway

Answer 4

patency, presence of tubes and respiratory assistance device

Question 5

what do the nurse need to check for breathing

Answer 5

RR and depth, presence of bilateral breath sounds, stridor, wheezes, hoarseness or decreased breath sounds

Question 6

what do the nurse need to check for circulation

Answer 6

pulse, BP, skin color, O2 sat

Question 7

signs of inadequate oxygenation (5)

Answer 7

1 delayed capillary 
2 weak peripheral pulses
3 decreased O2 saturation
4 restlessness
5 flushed

Question 8

what do you do in phase 1 of post anesthesia care

Answer 8

1 immediate post anesthesia period

2 ECG and more intense monitoring

Question 9

what do you do in phase 2 of post anesthesia care

Answer 9

1 ambulatory

2 fast tracking

Question 10

what is extended observation

Answer 10

extended care

Question 11

what is blended levels of care

Answer 11

various of levels offered in same environment

Question 12

nursing care in PACU

Answer 12

1  assess respiratory status
2 assess circulation
3 assess neurologic status
4 monitor wound
5 reduce N&V

Question 13

what should high risk client use to detect respiratory depression

Answer 13

the client use transcutaneous CO2 and end tidal CO2

Question 14

what should the nurse assess for neurologic status of patient

Answer 14

1 level of consciousness
2 orientation
3 sensory and motor status
4 size, equality, and reactivity of pupils

Question 15

what should the nurse assess for the body temperature

Answer 15

1 peripheral pulse
2 capillary refill
3 skin condition

Question 16

what should the nurse be alerted for regional anesthesia (5)

Answer 16

1 respiratory distress
2 hypotension
3 dysrhythmias
4 changes in HR
5 bleeding or hematoma

Question 17

general information in PACU report (4)

Answer 17

1 name & age
2 surgeon and ACP
3 surgical procedure
4 presence of tubes, drains, catheters, and IV lines

Question 18

patient history in PACU report (5)

Answer 18

1 indication for surgery
2 medical history
3 preop or baseline VS, lab & dx findings
4 level of consciousness, orientation
5 specific characteristics

Question 19

intraoperative management

Answer 19

1 anesthetic agents
2 last dose of opioids
3 total fluid replacement
4 total fluid replacement including BT
5 urine output

Question 20

respiratory problems when there is airway compromise (5)

Answer 20

1 airway obstruction 
2 hypoxemia 
3 hypoventilation
4 risk for aspiration
5 bronchospasm

Question 21

give examples of high risk individuals (4)

Answer 21

1 px given GA
2 older than 55
3 history of tobacco use
4 lung disease and sleep disorder

Question 22

give examples of postoperative respiratory complications (7)

Answer 22

1 airway obstruction
2 hypoxemia
3 atelectasis
4 pulmonary edema
5 aspiration 
6 bronchospasm
7 hypoventilation

Question 23

what could possibly happen when there is airway obstruction

Answer 23

blockage of airway by the patient’s tongue

Question 24

what could possibly happen when there is hypoxemia (3)

Answer 24

1 PaO2 less than 60mmHg
2 hypertension to hypotension
3 tachycardia to bradycardia

Question 25

what could possibly happen when there is atelectasis (2)

Answer 25

1 hypoxemia 2 bronchial obstruction caused by retained secretions 3 decreased respiratory excursion or GA

Question 26

what could possibly happen when there is pulmonary edema

Answer 26

accumulation of fluid in alveoli that could lead to fluid overload

Question 27

what could possible happen when there is aspiration

Answer 27

aspiration of gastric contents into the lungs

Question 28

what could possibly happen when there is hypoventilation

Answer 28

depression of central respiratory

Question 29

what is the assessment tool for sedation

Answer 29

richmond agitation sedation scale

Question 30

what is the nursing intervention for px recovering from GA (3)

Answer 30

1 teach coughing technique 2 change in position 1-2 hrs 3 adequate hydration

Question 31

what are the complications for cardiovascular system (3)

Answer 31

1 hypotension 2 hypertension 3 dysrhythmias

Question 32

give examples of high risk individuals (5)

Answer 32

``` 1 altered respiratory function 2 history of cardiovascular disease 3 older adults 4 debilitated 5 critically ill ```

Question 33

clinical signs for hypotension (5)

Answer 33

``` 1 disorientation 2 loss of consciousness 3 chest pain 4 oliguria 5 hypoxemia ```

Question 34

what could possibly happen when there is hypertension

Answer 34

1 pain 2 anxiety 3 bladder distention 4 respiratory distress

Question 35

what could possibly happen when there is hypokalemia

Answer 35

low serum k levels could make the heart's contractility weaker causing decreased cardiac output and tissue perfusion

Question 36

what is syncope

Answer 36

decreased cardiac output, fluid deficits or defects in cerebral perfusion

Question 37

venous thromboembolism is caused by

Answer 37

venous stasis, vein injury and hypercoagulable state