Emergency Response Procedures Flashcards

A patient receiving epidural morphine in the PACU develops respiratory rate of 6/min, sedation score of 3, and SpO2 of 89%. The correct naloxone dose to reverse respiratory depression while preserving analgesia is:

Answer: 0.04–0.1 mg IV titrated slowly

Small titrated doses of naloxone (0.04–0.1 mg) reverse opioid-induced respiratory depression while minimizing reversal of analgesia and avoiding acute pain crisis.

During a PACU fire emergency, which mnemonic guides the nurse's initial response sequence?

Answer: RACE (Rescue, Alarm, Contain, Extinguish)

The RACE mnemonic (Rescue, Alarm, Contain, Extinguish) provides the standardized fire response sequence in healthcare settings.

A patient in the PACU develops severe bronchospasm unresponsive to two doses of albuterol. The anesthesiologist orders magnesium sulfate. What is the primary mechanism by which magnesium relieves bronchospasm?

Answer: Blocks calcium-mediated smooth muscle contraction

Magnesium sulfate acts as a calcium antagonist, inhibiting calcium-mediated smooth muscle contraction and thereby causing bronchodilation.

A patient with an implanted cardiac defibrillator (ICD) develops ventricular fibrillation in the PACU and the ICD fails to fire. The nurse should:

Answer: Begin CPR and use the external defibrillator, placing pads away from the ICD generator

External defibrillation should proceed immediately; pads should be placed at least 8 cm from the ICD generator to avoid damaging the device.

A PACU patient who received spinal anesthesia for lower extremity surgery develops sudden hypotension, bradycardia, and nausea 45 minutes post-procedure. The spinal block level is assessed at T2. This complication is called:

Answer: High spinal with sympathectomy

A high spinal block at T2 causes extensive sympathetic blockade resulting in hypotension, bradycardia, and nausea due to loss of cardiac accelerator fibers.

When using the modified Aldrete scoring system to evaluate readiness for PACU discharge, a minimum score of how much is required?

Answer: 9

A modified Aldrete score of 9 or higher out of 10 is the accepted threshold for safe discharge from phase I PACU.

A pediatric patient in the PACU following adenotonsillectomy develops SpO2 of 88%, retractions, and a high-pitched inspiratory sound. After airway repositioning fails, the next intervention is:

Answer: Administer CPAP via facemask with 5–10 cmH2O

CPAP via facemask splints the airway open and recruits alveoli, making it the preferred initial intervention for post-extubation airway obstruction unresponsive to repositioning.