CPAN CPAN Post-Operative Complications and Interventions 2 — Questions and Answers
Question 1: What are early clinical signs of post-operative hemorrhage that a PACU nurse must monitor for?
- Hypertension and bradycardia with stable wound drainage
- Increasing heart rate, falling blood pressure, and increased wound drainage (Correct answer)
- Stable vital signs and minimal wound drainage throughout recovery
- Fever with flushing and warm extremities
Correct answer: Increasing heart rate, falling blood pressure, and increased wound drainage
Early hemorrhage signs include tachycardia, hypotension, and increasing wound drainage, all of which require immediate notification of the surgical team.
Question 2: How does post-operative atelectasis typically present in the PACU?
- Complete absence of symptoms with normal oxygen saturation
- Decreased breath sounds, reduced oxygen saturation, and possible fever (Correct answer)
- Hypertension and bradycardia with intact breath sounds
- Markedly increased urine output with normal respiratory status
Correct answer: Decreased breath sounds, reduced oxygen saturation, and possible fever
Post-operative atelectasis presents with decreased or absent breath sounds in affected lung areas, reduced oxygen saturation, and possible fever from lung collapse.
Question 3: Which intervention is most effective in preventing post-operative atelectasis in PACU patients?
- Complete bed rest and strict immobilization post-operatively
- Incentive spirometry and deep breathing exercises (Correct answer)
- Aggressive intravenous fluid administration
- Prophylactic antibiotic administration routinely
Correct answer: Incentive spirometry and deep breathing exercises
Incentive spirometry and deep breathing exercises promote alveolar expansion and are the most effective interventions for preventing post-operative atelectasis.
Question 4: What is malignant hyperthermia (MH) and why is it considered a critical PACU emergency?
- A mild post-operative fever treated with acetaminophen
- A potentially fatal hypermetabolic reaction to certain anesthetic agents characterized by hyperthermia, muscle rigidity, and acidosis (Correct answer)
- Normal temperature elevation expected after all general anesthesia cases
- A delayed allergic reaction to post-operative antibiotics
Correct answer: A potentially fatal hypermetabolic reaction to certain anesthetic agents characterized by hyperthermia, muscle rigidity, and acidosis
Malignant hyperthermia is a life-threatening pharmacogenetic disorder triggered by volatile anesthetics and succinylcholine, causing uncontrolled skeletal muscle metabolism.
Question 5: What is the first-line specific treatment for malignant hyperthermia?
- Cooling blankets and ice packs alone without any medication
- Dantrolene sodium administration combined with aggressive cooling and supportive care (Correct answer)
- Halting the procedure and observation only without pharmacologic treatment
- Administering additional anesthesia to stop skeletal muscle activity
Correct answer: Dantrolene sodium administration combined with aggressive cooling and supportive care
Dantrolene sodium is the specific antidote for malignant hyperthermia and must be given promptly along with aggressive cooling and supportive treatment.
Question 6: A patient develops hypotension 30 minutes after surgery. What is the PACU nurse's priority action?
- Document the finding and wait for spontaneous resolution
- Assess for the underlying cause, notify the physician, and initiate appropriate interventions based on findings (Correct answer)
- Immediately administer vasopressors without physician notification
- Increase the IV fluid rate to maximum without first notifying the physician
Correct answer: Assess for the underlying cause, notify the physician, and initiate appropriate interventions based on findings
Post-operative hypotension requires prompt systematic assessment to identify the underlying cause before appropriate targeted treatment can be initiated, with timely physician notification.
CPAN CPAN Post-Operative Complications and Interventions 2
What are early clinical signs of post-operative hemorrhage that a PACU nurse must monitor for?