CAPA Evidence-Based Practice in PACU 3 — Questions and Answers
Question 1: Evidence-based practice for preventing emergence delirium in pediatric PACU patients most strongly supports which intervention?
- Routine use of physostigmine upon awakening
- Parental presence during emergence from anesthesia (Correct answer)
- Prophylactic haloperidol for all pediatric patients
- Restricting sensory stimulation by keeping lights off
Correct answer: Parental presence during emergence from anesthesia
Research supports parental presence during emergence as an effective, low-risk strategy to reduce emergence delirium in children.
Question 2: A PACU nurse is conducting a literature review on oxygen supplementation after ambulatory surgery. Which evidence-based finding most accurately reflects current guidelines?
- All patients should receive supplemental oxygen for at least 2 hours post-op
- Supplemental oxygen should be titrated to maintain SpO2 ≥92–95% per patient risk (Correct answer)
- Hyperoxia has no known adverse effects and should be used liberally
- Oxygen therapy should be withheld to encourage deep breathing
Correct answer: Supplemental oxygen should be titrated to maintain SpO2 ≥92–95% per patient risk
Evidence supports individualized, titrated oxygen therapy targeting SpO2 goals rather than routine prophylactic high-flow oxygen.
Question 3: Which EBP framework is most commonly referenced in ASPAN standards for structuring clinical inquiry in perianesthesia nursing?
- SBAR communication framework
- Iowa Model of Evidence-Based Practice (Correct answer)
- TeamSTEPPS safety model
- Lean Six Sigma quality model
Correct answer: Iowa Model of Evidence-Based Practice
The Iowa Model is a widely adopted EBP framework that guides nurses through problem identification, evidence appraisal, and practice implementation.
Question 4: Evidence-based guidelines for postoperative fluid management in ambulatory patients recommend which approach to IV fluid therapy?
- Liberal fluid replacement at 20 mL/kg for all patients
- Goal-directed fluid therapy guided by hemodynamic response (Correct answer)
- Restricting all IV fluids to minimize urinary output
- Fixed 1-liter bolus given upon PACU admission regardless of status
Correct answer: Goal-directed fluid therapy guided by hemodynamic response
Goal-directed fluid therapy, guided by patient response and hemodynamic parameters, is supported by evidence to optimize outcomes.
Question 5: When implementing an evidence-based fall prevention program in Phase II recovery, which intervention has the strongest research support?
- Bed alarms for all patients over age 50
- Individualized risk assessment combined with targeted interventions (Correct answer)
- Mandatory 30-minute bed rest for all ambulatory patients post-PACU
- Routine bilateral wrist restraints during transfer
Correct answer: Individualized risk assessment combined with targeted interventions
Individualized fall risk assessment using validated tools, paired with targeted interventions, is the most evidence-supported fall prevention strategy.
Question 6: A quality improvement team analyzes PACU unplanned admission rates. Which EBP step does this represent?
- Formulating a PICO question
- Appraising the evidence
- Identifying a clinical problem or trigger (Correct answer)
- Translating evidence into practice
Correct answer: Identifying a clinical problem or trigger
Analyzing outcome data to identify a problem is the first step in EBP, representing the problem identification or trigger phase.
Question 7: According to evidence-based postoperative care, which practice reduces the risk of postoperative urinary retention (POUR) in ambulatory patients?
- Mandatory urinary catheterization for all patients receiving neuraxial anesthesia
- Avoiding routine mandatory voiding requirements for low-risk procedures (Correct answer)
- Administering furosemide to promote bladder emptying
- Restricting IV fluids to less than 200 mL intraoperatively
Correct answer: Avoiding routine mandatory voiding requirements for low-risk procedures
Evidence shows that eliminating mandatory voiding requirements for low-risk patients reduces unnecessary delays and catheterizations without increasing POUR.
CAPA Evidence-Based Practice in PACU 3
Evidence-based practice for preventing emergence delirium in pediatric PACU patients most strongly supports which intervention?