Patient Assessment and Evaluation Flashcards

A PACU patient who received general anesthesia with succinylcholine develops jaw rigidity, rapidly rising temperature, and muscle rigidity 30 minutes post-induction. Which lab value is the earliest indicator of the suspected complication?

Answer: Elevated serum lactate

Elevated serum lactate from anaerobic metabolism is one of the earliest laboratory indicators of malignant hyperthermia, reflecting increased cellular oxygen consumption.

When performing a post-anesthesia neurological assessment, which finding indicates the highest level of consciousness on the AVPU scale?

Answer: Patient is alert and oriented

On the AVPU scale, 'A' (Alert) represents the highest level, indicating the patient is fully conscious without any external stimulation.

A 68-year-old patient in the PACU becomes agitated and tries to remove the IV line 45 minutes after emergence from general anesthesia. Which assessment finding would most suggest emergence delirium rather than pain?

Answer: Non-purposeful thrashing with inconsolable crying unrelated to stimuli

Non-purposeful, inconsolable behavior unrelated to external stimuli is characteristic of emergence delirium, distinguishing it from pain-related agitation.

During PACU assessment, a patient's capnography shows a waveform with a gradually rising plateau and a prolonged expiratory phase. This pattern is most consistent with:

Answer: Obstructive airway disease such as bronchospasm

A shark-fin or oblique capnography waveform with prolonged expiration indicates obstructive airway disease due to impaired exhalation.

A post-anesthesia patient's Steward Recovery Score is being calculated. Which three parameters does this scoring system evaluate?

Answer: Respiration, consciousness, and movement

The Steward Recovery Score, used primarily in pediatric patients, evaluates respiration, consciousness, and movement to determine readiness for discharge from Phase I PACU.

A patient with a history of obstructive sleep apnea (OSA) is in the PACU after laparoscopic cholecystectomy. Which assessment finding warrants the highest concern?

Answer: Loud snoring with SpO2 dropping to 86% during sleep

OSA patients are at highest risk for airway obstruction during sleep; SpO2 dropping to 86% during snoring indicates significant upper airway obstruction requiring intervention.

When assessing a PACU patient for residual neuromuscular blockade, which clinical finding best confirms adequate reversal?

Answer: Sustained head lift for 5 seconds

A sustained head lift for 5 seconds requires adequate muscle strength and is a reliable clinical indicator of sufficient reversal of neuromuscular blockade.