Phases of Perianesthesia Care and Discharge Criteria Flashcards

Per ASA guidance, a patient with obstructive sleep apnea should not be discharged to an unmonitored setting until:

Answer: Room-air SpO2 returns to baseline and no hypoxemia or obstruction occurs when the patient is left undisturbed

OSA patients should show stable room-air saturation without hypoxemia or obstruction, ideally while observed asleep, before discharge.

Which finding best shows that spinal anesthesia has resolved enough for ambulatory discharge?

Answer: Return of perianal (S4-S5) sensation, plantar flexion, and proprioception of the great toe

Perianal sensation, plantar flexion, and great-toe proprioception indicate block regression adequate for safe ambulation.

A patient is discharged home with a functioning interscalene block and an insensate arm. Which action is most important?

Answer: Protect the limb in a sling and teach injury precautions and when pain will return

Patients may go home with an insensate limb if it is protected and they understand precautions and the transition to oral analgesia.

Under ASA guidelines, a PACU RN may discharge a patient without a separate physician evaluation when:

Answer: Discharge criteria approved by the medical staff are met and the responsible provider's name is documented

Nurse-driven discharge is acceptable when medical staff-approved criteria are applied and documented.

A patient who received midazolam and fentanyl insists on driving home alone. What is the nurse's most appropriate action?

Answer: Explain the risks, notify the anesthesia provider/surgeon, and document thoroughly

The nurse must educate, escalate to the provider, and document, without unlawfully restraining a competent patient.

Which pain status best meets ambulatory discharge criteria?

Answer: Pain acceptable to the patient and manageable with oral analgesics

Discharge requires pain at a level acceptable to the patient that can be managed with oral medications at home.

When is a post-discharge follow-up phone call to an ambulatory surgery patient typically made?

Answer: Within 24 hours, or the next business day

Follow-up calls are usually made within 24 hours or the next business day to assess complications, pain, PONV, and understanding of instructions.