CPAN Respiratory and Airway Management Flashcards

A PACU patient has shallow respirations and a tidal volume of 3 mL/kg after general anesthesia. What is the likely cause?

Answer: Residual neuromuscular blockade causing inadequate respiratory effort

Residual neuromuscular blockade from non-depolarizing muscle relaxants is a common cause of inadequate tidal volumes and respiratory weakness post-anesthesia.

Which test best assesses for adequate reversal of neuromuscular blockade before extubation in the PACU?

Answer: Train-of-four (TOF) ratio ≥0.9 with qualitative or quantitative neuromuscular monitoring

A train-of-four ratio of 0.9 or greater using neuromuscular monitoring confirms adequate reversal of neuromuscular blockade and safe muscle function.

A patient develops acute bronchospasm in the PACU after extubation. What is the first-line pharmacological treatment?

Answer: Inhaled short-acting beta-2 agonist (e.g., albuterol)

Inhaled short-acting beta-2 agonists such as albuterol are the first-line treatment for bronchospasm, providing rapid bronchodilation with minimal systemic effects.

How does the PACU nurse differentiate between hypoxemia caused by hypoventilation versus ventilation-perfusion (V/Q) mismatch?

Answer: Hypoventilation improves with 100% oxygen alone; V/Q mismatch does not reliably correct with oxygen alone and is associated with elevated CO2

Hypoventilation causes hypoxemia with elevated CO2 that responds to increasing ventilation, while V/Q mismatch (e.g., atelectasis, PE) may not fully correct with oxygen alone.

Which nursing intervention best prevents post-operative atelectasis in PACU patients?

Answer: Encouraging incentive spirometry and deep breathing exercises every 1-2 hours

Regular incentive spirometry and deep breathing promote alveolar recruitment and prevent atelectasis, which is common after general anesthesia due to reduced functional residual capacity.

A PACU patient who underwent oral surgery develops progressive swelling of the tongue and uvula with increasing respiratory difficulty. What condition should the nurse suspect?

Answer: Angioedema or airway edema requiring urgent airway management

Progressive tongue and uvular swelling with respiratory difficulty after oral or head/neck surgery suggests angioedema or surgical edema requiring immediate airway intervention.