Skills and Competencies Flashcards

A patient with a history of malignant hyperthermia is admitted to the PACU. The CPAN knows the most important monitoring parameter specific to this risk is:

Answer: End-tidal CO2 and temperature trending

Rising end-tidal CO2 and temperature are early hallmarks of malignant hyperthermia crisis, requiring immediate recognition and dantrolene administration.

Which assessment finding in a post-tonsillectomy pediatric patient should prompt the PACU nurse to immediately notify the surgeon?

Answer: Frequent swallowing and restlessness

Frequent swallowing in a post-tonsillectomy patient is a key sign of hemorrhage as the child swallows blood pooling in the posterior pharynx.

A PACU patient receiving patient-controlled analgesia (PCA) with morphine has a respiratory rate of 7 breaths/min and pinpoint pupils. The CPAN should first:

Answer: Administer naloxone 0.4 mg IV and prepare to repeat dosing

Signs of opioid toxicity with respiratory depression require immediate naloxone administration to reverse life-threatening respiratory compromise.

When performing a Romberg test assessment in Phase II recovery, the nurse is evaluating:

Answer: Proprioception and balance for safe ambulation

The Romberg test assesses proprioceptive balance, which must be intact before a patient is considered safe for independent ambulation after neuraxial anesthesia.

A post-cardiac surgery patient in the PACU develops cardiac tamponade. Which hemodynamic pattern is most consistent with this diagnosis?

Answer: Beck's triad: hypotension, muffled heart sounds, elevated JVD

Beck's triad — hypotension, muffled heart sounds, and elevated jugular venous distension — is the classic presentation of cardiac tamponade.

The modified Aldrete scoring system used in PACU Phase I recovery evaluates which five parameters?

Answer: Activity, respiration, circulation, consciousness, and oxygen saturation

The modified Aldrete score assesses activity, respiration, circulation, consciousness, and oxygen saturation to determine readiness for Phase II or discharge.

A CPAN is caring for a patient who had an open bowel resection. The patient reports severe pain rated 9/10 unrelieved by current IV opioids. An appropriate multimodal strategy to consider includes:

Answer: Administering IV ketorolac per protocol as an opioid-sparing adjunct

Ketorolac is an NSAID analgesic that provides opioid-sparing pain control through a different mechanism, supporting multimodal analgesia strategies.