PACU PRACTICE EXAM LATEST UPDATED
Post-operative care - ANSWER commences with admission to the PACU until
the patient is D/C.
Assessments in the PACU include respiratory, circulatory, pain, temperature,
surgery site, airway, breathing, and neurologic evaluations. Equipment should
be maintained properly.
Admission Report Information: ANSWER general patient information: identity,
arrival time, surgeon, and surgical procedure
Patient history: medical history, allergies, and LOC.
ANSWER: Titrate drips, drugs administered, estimated blood loss, fluids given,
urine and NG output, drain output.
When assessing a PACU patient, consider their airway, breathing, circulation,
vital signs, neurological status, anaesthetic recovery, surgery site, IV lines, and
infusion rates.
Respiratory Problems ANSWER airway patency, chest symmetry, depth-rate-
character of respirations, pulse oximetry, sputum/mucus, crackles in the lungs,
use of abdominal muscles, tachypnea, gasping, anxiety, disorientation,
rapid/thin pulse
Respiratory Problems Post-operative symptoms include pulmonary edema,
bronchospasms, and hypoventilation.
Nursing Management of Airway Problems - Answer Evaluate the airway and
breath sounds. Jaw thrust, chin raise. oxygen, stimulation, oral airway when
conscious-> raise HOB
, Why are patients on oxygen post-op? - ANSWER remove anesthetic gases,
increase demand for oxygen owing to (decreased blood volume, increased
cellular metabolism).
Laryngospasm - ANSWER partial or total spasm of vocal cords, history of
smoking, difficult intubations, or history of vocal cord surgery.
SSX: agitation and hypoxia (partial or complete obstruction)
Nursing Management of Laryngospasms - ANSWER gentle suctioning,
maintain ideal airway position, 100% oxygen, positive pressure ventilation
(bagging) **may require re-intubation
Pulmonary edema is characterized by abnormal fluid accumulation in the
alveoli and interstitial spaces of the lungs, which can lead to heart failure, fluid
overload, prolonged airway obstruction, infection, and aspiration.
What causes atelectasis? - ANSWER: mucus plugs, hypoventilation, persistent
recumbent position, ineffective coughing, history of smoking.
Nursing interventions for atelectasis: ANSWER incentive spirometer.
Encourage coughing with deep breathing (10 times per hour) and turn cough.
Deep breathing and ambulation
Potential Neurologic Problems: ANSWER Emergent delirium is agitation and
disorientation caused by hypoxia or a ANSWER to anesthetic drugs.
Delayed awakening: extended drug interaction caused by drugs.
To treat acute pain, opioid analgesics such as fentanyl citrate, morphine sulfate,
and mephedrine hydrochloride (demerol) can be administered intravenously or
via PCA.
Causes of pain: skin and tissue damage, muscle spasms.
Symptoms may include post-operative movement, full bladder, and anxiety that
affects pain threshold.
ANSWER: Patient Controlled Analgesia Pump
Self-administered, predetermined dose
Basal rate is a continuous and steady rate.