CAPA Discharge Criteria & Planning 4 — Questions and Answers
Question 1: A pediatric patient underwent tonsillectomy. Which discharge criterion is MOST specific to this population?
- Tolerating oral fluids without vomiting
- Ability to walk to the car independently
- SpO2 ≥95% on room air without stridor (Correct answer)
- Pain score ≤2/10 on numeric rating scale
Correct answer: SpO2 ≥95% on room air without stridor
Post-tonsillectomy pediatric patients must demonstrate airway stability with SpO2 ≥95% on room air and no stridor before discharge.
Question 2: Under which circumstance may a patient be discharged without voiding after ambulatory surgery?
- When the surgery lasted less than 30 minutes
- When the patient received only local anesthesia for a non-pelvic procedure with low fluid intake (Correct answer)
- When the patient reports a strong urge to void
- When the bladder scan shows 200 mL
Correct answer: When the patient received only local anesthesia for a non-pelvic procedure with low fluid intake
Current guidelines allow discharge without voiding when regional/neuraxial anesthesia was not used, the procedure was not pelvic/urological, and fluid intake was minimal.
Question 3: A patient's escort arrives intoxicated and is unable to drive safely. What action should the perianesthesia nurse take?
- Discharge the patient and call a cab
- Contact a sober alternative escort or arrange safe transport; do not discharge to an intoxicated escort (Correct answer)
- Discharge the patient since a responsible adult is technically present
- Administer naloxone to the escort to sober them up
Correct answer: Contact a sober alternative escort or arrange safe transport; do not discharge to an intoxicated escort
An intoxicated escort cannot provide safe supervision or transport; discharge must be delayed until a responsible alternative is secured.
Question 4: Which assessment tool is specifically designed to evaluate readiness for discharge from Phase II (ambulatory surgery discharge)?
- Modified Aldrete Score
- Ramsay Sedation Scale
- Post-Anesthetic Discharge Scoring System (PADSS) (Correct answer)
- Richmond Agitation-Sedation Scale (RASS)
Correct answer: Post-Anesthetic Discharge Scoring System (PADSS)
PADSS evaluates vital signs, ambulation, nausea/vomiting, pain, and surgical bleeding specifically for Phase II ambulatory discharge readiness.
Question 5: A diabetic patient is being discharged after ambulatory cholecystectomy. Which additional discharge instruction is MOST critical for this patient?
- Increase carbohydrate intake to prevent hypoglycemia during recovery
- Monitor blood glucose closely and adjust insulin per physician guidance during NPO/diet transition (Correct answer)
- Avoid all oral hypoglycemics for one week
- Resume all diabetes medications immediately regardless of oral intake status
Correct answer: Monitor blood glucose closely and adjust insulin per physician guidance during NPO/diet transition
Postoperative changes in oral intake, stress response, and activity require close blood glucose monitoring and individualized insulin adjustment.
Question 6: A patient who received a femoral nerve block for knee surgery is being discharged. Which safety instruction is MOST important?
- Apply ice to the groin to extend the block duration
- Do not bear weight on the affected leg until full motor strength returns (Correct answer)
- Perform range-of-motion exercises while the block is active
- Massage the thigh to enhance medication absorption
Correct answer: Do not bear weight on the affected leg until full motor strength returns
A femoral nerve block impairs quadriceps strength and proprioception, creating fall risk; weight-bearing should be avoided until motor function fully returns.
Question 7: Which of the following represents an appropriate MINIMUM criterion for oral fluid tolerance before ambulatory discharge?
- Patient consumed at least 500 mL of clear liquids
- Patient tolerates a small amount of fluid or crackers without nausea or vomiting (Correct answer)
- Patient has eaten a full light meal without symptoms
- Patient requests food and is hungry
Correct answer: Patient tolerates a small amount of fluid or crackers without nausea or vomiting
Routine mandatory oral fluid intake before discharge is no longer required; tolerance of small amounts without vomiting is sufficient for most procedures.
CAPA Discharge Criteria & Planning 4
A pediatric patient underwent tonsillectomy.
Which discharge criterion is MOST specific to this population?