Pediatric Perianesthesia Nursing Flashcards

Which condition is a contraindication to same-day discharge after ambulatory surgery in a former premature infant?

Answer: Postconceptual age less than 60 weeks

Former premature infants with postconceptual age under 60 weeks are at high risk for post-anesthetic apnea and require overnight monitoring, making same-day discharge unsafe.

A 7-year-old child is in Phase II recovery and reports nausea. The nurse notes no vomiting has occurred. What is the most appropriate initial intervention?

Answer: Administer ondansetron IV and encourage slow deep breathing

Ondansetron is the first-line antiemetic in pediatric patients, and non-pharmacologic measures like deep breathing can also reduce nausea in the ambulatory setting.

When performing a pain assessment in a 5-year-old, which scale is most age-appropriate?

Answer: Faces Pain Scale–Revised (FPS-R)

The Faces Pain Scale–Revised (FPS-R) is validated for children aged 4 and older and uses facial expressions that children can reliably self-report.

A child is brought to the PACU after hypospadias repair. Which assessment finding should the perianesthesia nurse prioritize?

Answer: Urine output and catheter patency

After hypospadias repair, ensuring catheter patency and adequate urine output is the priority as catheter obstruction can cause urinary retention and bladder distension.

Which statement about pediatric IV fluid tonicity in the perianesthesia period is correct?

Answer: Hypotonic fluids are avoided due to risk of hyponatremia and cerebral edema

Current guidelines recommend isotonic or near-isotonic fluids for pediatric perioperative maintenance due to the serious risk of hyponatremia-induced cerebral edema from hypotonic solutions.

A 12-year-old girl is scheduled for laparoscopic appendectomy under general anesthesia. Which PONV risk factor is specific to her demographic?

Answer: Female sex after puberty substantially increases PONV risk

Female sex is a major adult PONV risk factor that becomes significant after puberty, and post-pubertal adolescent girls carry adult-level PONV risk.

A 4-year-old in the PACU has a temperature of 38.9°C after adenotonsillectomy. The nurse should first:

Answer: Assess for signs of malignant hyperthermia including muscle rigidity and rising CO2

Any unexplained fever and temperature elevation after volatile anesthesia must first be assessed for malignant hyperthermia, which is a life-threatening emergency requiring immediate intervention.