CAPA Thermoregulation & Fluid Management 5

Question 1

A patient in Phase II PACU reports dizziness and nausea after attempted ambulation. Orthostatic vital signs show BP drop of 25 mmHg systolic. The MOST appropriate intervention is:

Accepted Answer

Return patient to supine, give a 250 mL IV fluid bolus, and reassess

Answer

Symptomatic orthostatic hypotension indicating volume depletion requires fluid bolus and reassessment before safe discharge can occur.

Question 2

Which warming method is CONTRAINDICATED in a patient with peripheral vascular disease undergoing ambulatory foot surgery?

Accepted Answer

Direct heating pad applied to the surgical extremity

Answer

Direct heat application to ischemic extremities in peripheral vascular disease can cause thermal injury due to impaired sensation and circulation.

Question 3

A patient's intraoperative urine output averages 15 mL/hr during a 2-hour ambulatory surgery despite adequate IV fluids. Which medication history is MOST likely responsible?

Accepted Answer

Preoperative ibuprofen use

Answer

NSAIDs inhibit prostaglandin-mediated renal afferent arteriolar dilation, reducing GFR and urine output, especially under anesthesia.

Question 4

In the ambulatory setting, which factor MOST strongly predicts the need for IV fluid resuscitation in PACU rather than oral hydration?

Accepted Answer

Procedure duration greater than 60 minutes with significant blood loss

Answer

Significant intraoperative blood loss during longer procedures creates volume deficits that require IV replacement rather than oral hydration.

Question 5

The target core temperature for discharge from Phase I PACU per ASPAN standards is:

Accepted Answer

Above 36.0°C

Answer

ASPAN guidelines require a minimum core temperature of 36.0°C before Phase I discharge to prevent complications of hypothermia.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Thermoregulation & Fluid Management 5