Skills and Competencies Flashcards

A CPAN is preparing to transfer a patient from Phase I to Phase II recovery. Which criterion must be met before this transfer?

Answer: Pain must be controlled at an acceptable level with a stable airway and hemodynamics

Transfer to Phase II requires that pain is managed acceptably and that the airway and hemodynamics are stable, not that the patient is fully ambulatory.

A patient in the PACU after abdominal surgery develops sudden, severe hypotension, tachycardia, and a rigid, distended abdomen. These findings suggest:

Answer: Acute hemorrhage or anastomotic leak requiring emergent notification

Sudden hemodynamic instability with abdominal rigidity after abdominal surgery signals a potentially catastrophic intra-abdominal complication requiring immediate surgical team notification.

The CPAN is caring for a patient post-carotid endarterectomy. Which neurological finding requires IMMEDIATE provider notification?

Answer: New unilateral facial droop and arm weakness

New focal neurological deficits after carotid endarterectomy indicate possible cerebral ischemia or stroke and constitute a neurovascular emergency.

Which intervention is most effective in preventing post-operative respiratory complications in Phase I PACU patients?

Answer: Encouraging deep breathing exercises, coughing, and early semi-upright positioning

Deep breathing, coughing, and semi-upright positioning promote lung expansion and secretion clearance, reducing atelectasis and pneumonia risk post-operatively.

A CPAN is managing a patient with epidural analgesia for post-thoracotomy pain. The nurse notes the patient has bilateral lower extremity weakness and urinary retention. The priority action is:

Answer: Stop the epidural infusion and notify the anesthesia provider immediately

New bilateral weakness and urinary retention may indicate epidural hematoma or excessive local anesthetic spread, both emergencies requiring immediate provider notification.

When caring for a bariatric patient in the PACU, the CPAN should position the patient in which way to optimize ventilation?

Answer: Reverse Trendelenburg or head-of-bed elevated 30–45 degrees

Elevating the head of bed in obese patients reduces diaphragmatic pressure from abdominal contents, improving functional residual capacity and oxygenation.

A CPAN is discharging a patient from Phase II ambulatory surgery. Per ASPAN standards, which statement about voiding prior to discharge is most accurate?

Answer: Voiding is required only for patients who received neuraxial anesthesia or had urologic/pelvic surgery

ASPAN guidelines recommend voiding prior to discharge specifically for patients who received neuraxial anesthesia or underwent procedures affecting bladder function.