Skills and Competencies Flashcards

A PACU patient receiving supplemental oxygen via nasal cannula has an SpO2 of 91% and is difficult to arouse. What is the priority intervention?

Answer: Apply jaw-thrust maneuver and reassess airway patency

Airway obstruction is the most common cause of hypoxia in the immediate post-anesthesia period and must be corrected before pharmacologic intervention.

Which medication is the first-line reversal agent for residual neuromuscular blockade from rocuronium or vecuronium?

Answer: Sugammadex

Sugammadex selectively encapsulates and reverses aminosteroid neuromuscular blocking agents such as rocuronium and vecuronium.

A post-thyroidectomy patient in the PACU develops stridor and increasing respiratory distress 2 hours after surgery. The nurse's priority action is to:

Answer: Notify the surgeon immediately and prepare for emergency airway management

Post-thyroidectomy stridor may indicate hematoma compressing the trachea, a surgical emergency requiring immediate provider notification and potential airway intervention.

When assessing adequacy of neuromuscular reversal, the CPAN should confirm the patient can:

Answer: Sustain a head lift for 5 seconds

A sustained 5-second head lift indicates adequate respiratory muscle strength and reliable reversal of neuromuscular blockade.

A patient in Phase I recovery has a blood pressure of 86/50 mmHg after spinal anesthesia for knee replacement. The most appropriate initial intervention is:

Answer: Infuse a 500 mL normal saline bolus rapidly

Spinal-induced hypotension is commonly caused by vasodilation and reduced preload; a fluid bolus is the first-line treatment to restore hemodynamic stability.

Which finding in a post-laparoscopic patient would alert the PACU nurse to possible pneumothorax?

Answer: Unilateral absent breath sounds with tracheal deviation

Absent unilateral breath sounds with tracheal deviation toward the opposite side are hallmark signs of tension pneumothorax requiring emergent intervention.

A PACU patient develops sudden onset shivering after general anesthesia. The CPAN understands this increases:

Answer: Oxygen consumption by up to 400%

Post-anesthesia shivering dramatically increases metabolic oxygen demand, which can be dangerous in patients with cardiac or respiratory compromise.